Individual
MS. COURTNEY LYNNE BENNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOT, OTR/L
Contact information
Practice address
511 N 12TH ST E, RIVERTON, WY 82501-3805
(307) 438-1768
(307) 460-5791
Mailing address
511 N 12TH ST E, RIVERTON, WY 82501-3805
(307) 438-1768
(307) 460-5791
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
9834370-4201
UT
225XM0800X
Mental Health Occupational Therapist
9834370-4201
UT
225XP0200X
Pediatric Occupational Therapist
9834370-4201
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
225X00000X
—
ID
05
—
3008546
—
UT
Enumeration date
08/22/2016
Last updated
05/28/2025
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