Provider Demographics
NPI:1316572969
Name:LENOX, BETHANY JOY (MS OTR/L)
Entity Type:Individual
Prefix:
First Name:BETHANY
Middle Name:JOY
Last Name:LENOX
Suffix:
Gender:F
Credentials:MS OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 S PARK AVE
Mailing Address - Street 2:
Mailing Address - City:KANE
Mailing Address - State:PA
Mailing Address - Zip Code:16735-1230
Mailing Address - Country:US
Mailing Address - Phone:814-969-0289
Mailing Address - Fax:
Practice Address - Street 1:7501 LEAD MINE RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-5847
Practice Address - Country:US
Practice Address - Phone:984-255-7712
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-04
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12963225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist