Provider Demographics
NPI:1255862751
Name:BENNETT, YVETTE (LPTA)
Entity Type:Individual
Prefix:
First Name:YVETTE
Middle Name:
Last Name:BENNETT
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 HIGHLAND ST
Mailing Address - Street 2:
Mailing Address - City:AMESBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01913-2201
Mailing Address - Country:US
Mailing Address - Phone:978-388-1858
Mailing Address - Fax:
Practice Address - Street 1:53 HIGHLAND ST
Practice Address - Street 2:
Practice Address - City:AMESBURY
Practice Address - State:MA
Practice Address - Zip Code:01913-2201
Practice Address - Country:US
Practice Address - Phone:978-388-1858
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-26
Last Update Date:2017-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2196225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant