Provider Demographics
NPI:1326841362
Name:BENTLEY, CAMMERON MARIE
Entity type:Individual
Prefix:
First Name:CAMMERON
Middle Name:MARIE
Last Name:BENTLEY
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5274 APACHE TRL
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:MI
Mailing Address - Zip Code:48625-8505
Mailing Address - Country:US
Mailing Address - Phone:719-293-3200
Mailing Address - Fax:
Practice Address - Street 1:789 N CLARE AVE
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:MI
Practice Address - Zip Code:48625-8250
Practice Address - Country:US
Practice Address - Phone:989-539-2141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-27
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator