Individual
MADELINE MAE MICHELLE BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2010 CHESTNUT ST, VAN BUREN, AR 72956-5321
(479) 471-9600
(479) 430-7596
Mailing address
2010 CHESTNUT ST, VAN BUREN, AR 72956-5321
(479) 471-9600
(479) 430-7596
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTR3933
AR
Other
Enumeration date
04/19/2024
Last updated
04/19/2024
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