Individual
OCTAVIA BENTUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12225 GREENVILLE AVE # 600, DALLAS, TX 75243-9362
(888) 265-1068
Mailing address
12225 GREENVILLE AVE # 600, DALLAS, TX 75243-9362
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
43535
TX
2355S0801X
Speech-Language Assistant
7772
CA
Other
Enumeration date
03/21/2023
Last updated
10/17/2023
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