Individual
MARIO BENCIVENGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR/L, CHT
Contact information
Practice address
100 BREWSTER BLVD, CAMP LEJEUNE, NC 28547-2575
(910) 450-4750
(910) 450-3406
Mailing address
100 BREWSTER BLVD, CAMP LEJEUNE, NC 28547-2575
(910) 450-4750
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
—
—
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
3790
CT
Other
Enumeration date
03/10/2011
Last updated
03/12/2021
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