Provider Demographics
NPI:1215329792
Name:BENTLEY, DANIELLE (OTR/L)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:BENTLEY
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 71
Mailing Address - Street 2:
Mailing Address - City:WHITESBURG
Mailing Address - State:KY
Mailing Address - Zip Code:41858-0071
Mailing Address - Country:US
Mailing Address - Phone:606-335-7050
Mailing Address - Fax:
Practice Address - Street 1:1490 PARK AVE NW STE 1
Practice Address - Street 2:
Practice Address - City:NORTON
Practice Address - State:VA
Practice Address - Zip Code:24273-1631
Practice Address - Country:US
Practice Address - Phone:276-439-1450
Practice Address - Fax:276-439-1451
Is Sole Proprietor?:No
Enumeration Date:2015-02-20
Last Update Date:2021-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYR5359225X00000X
VA225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist