Provider Demographics
NPI:1699902544
Name:BENNETT, KAREN LYNNE (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:LYNNE
Last Name:BENNETT
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 1:16 MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04270-3579
Mailing Address - Country:US
Mailing Address - Phone:207-743-7035
Mailing Address - Fax:207-743-2970
Practice Address - Street 1:16 MADISON AVE
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:ME
Practice Address - Zip Code:04270-3579
Practice Address - Country:US
Practice Address - Phone:207-743-7035
Practice Address - Fax:207-743-2970
Is Sole Proprietor?:No
Enumeration Date:2009-06-18
Last Update Date:2009-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOT386225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics