Individual
KAY D BENJAMIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
3840 HULEN ST HTN, CLIENT ACCOUNTING, FT. WORTH, TX 76107-7277
(817) 569-4300
Mailing address
PO BOX 2603 HTN, CLIENT ACCOUNTING, FT. WORTH, TX 76113-2603
(817) 569-4300
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
115132
TX
225X00000X
Occupational Therapist
2573
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
311991901
—
TX
05
—
770017
—
AZ
01
—
886T09
BCBS
—
Enumeration date
09/28/2006
Last updated
06/12/2013
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