Individual
MAKENZIE MARIE BENOIT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTA
Contact information
Practice address
304 EMMA, DIANA, TX 75640-4010
(903) 808-5915
Mailing address
304 EMMA, DIANA, TX 75640-4010
(903) 808-5915
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
217778
TX
Other
Enumeration date
05/17/2023
Last updated
05/17/2023
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