Individual
DORIAN BETH BANNISTER
Active
Individual
DORIAN BETH BANNISTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L CLT
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
004413
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
004413
OT LICENSE
GA
01
—
OT1822
OT LICENSE
ME
01
—
OT600002876
LICENSE
WA
Enumeration date
09/26/2006
Last updated
04/28/2011
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