Individual
KAITLAN TREVA BENNINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
13123 E 16TH AVE, AURORA, CO 80045-7106
(720) 777-1234
Mailing address
14203 E MISSISSIPPI AVE APT 370, AURORA, CO 80012-6120
(801) 391-3673
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
OT.0006268
CO
225XP0200X
Pediatric Occupational Therapist
Primary
OT.0006268
CO
Other
Enumeration date
11/21/2019
Last updated
12/18/2019
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