Provider Demographics
NPI:1184822124
Name:BENNETT, TERRI MARGARET (OTR)
Entity Type:Individual
Prefix:
First Name:TERRI
Middle Name:MARGARET
Last Name:BENNETT
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 GIGI ST
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80104-1615
Mailing Address - Country:US
Mailing Address - Phone:303-663-1813
Mailing Address - Fax:
Practice Address - Street 1:701 E HAMPDEN AVE STE 415
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-2759
Practice Address - Country:US
Practice Address - Phone:303-597-1724
Practice Address - Fax:303-788-5460
Is Sole Proprietor?:No
Enumeration Date:2007-07-10
Last Update Date:2008-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDNBCOT1020341225XN1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XN1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistNeurorehabilitation