Individual
BLAKE BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTD, OTR/L
Contact information
Practice address
1500 N MISSISSIPPI ST, LITTLE ROCK, AR 72207-5851
(501) 217-8600
Mailing address
12423 PLEASANT VIEW DR, LITTLE ROCK, AR 72212-2220
(501) 765-6422
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTR3736
AR
Other
Enumeration date
11/21/2022
Last updated
11/21/2023
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