Individual
SARAH ELISE BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
663 COLUSA AVE, BERKELEY, CA 94707-1517
(415) 717-2691
Mailing address
663 COLUSA AVENUE, BERKELEY, CA 94707
(415) 717-2691
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
5770
CA
314000000X
Skilled Nursing Facility
Primary
5770
CA
Other
Enumeration date
06/10/2010
Last updated
06/10/2010
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