Individual
MRS. AMANDA BETH BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
807 WEST AVE, ELYRIA, OH 44035-5898
(440) 284-9346
Mailing address
28 FOREST ST, NORWALK, OH 44857-2425
(419) 681-2083
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
04039
OH
Other
Enumeration date
07/20/2010
Last updated
10/22/2014
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