Individual
MEGAN BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
3320 BROADWAY RD, ALEXANDER, NY 14005-9702
(716) 512-4032
Mailing address
3320 BROADWAY RD, ALEXANDER, NY 14005-9702
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2404236
NY
Other
Enumeration date
12/07/2023
Last updated
12/07/2023
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