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Individual

MS. SUSAN MARIE BENNETT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
200 W CEDAR ST, HESSTON, KS 67062-8100
(620) 327-0400
Mailing address
2214 S ESTELLE ST, WICHITA, KS 67211-5505
(316) 303-2595

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
18-00139
KS
224ZE0001X
Environmental Modification Occupational Therapy Assistant
18-00139
KS

Other

Enumeration date
04/09/2016
Last updated
04/09/2016
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