Provider Demographics
NPI:1326826678
Name:BENNETT, HANNAH ANDLYN (MOT)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:ANDLYN
Last Name:BENNETT
Suffix:
Gender:F
Credentials:MOT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 N LINCOLN ST APT 501
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80203-3947
Mailing Address - Country:US
Mailing Address - Phone:214-356-5312
Mailing Address - Fax:
Practice Address - Street 1:7720 E BELLEVIEW AVE STE B250
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-2686
Practice Address - Country:US
Practice Address - Phone:720-287-4185
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-18
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0008153225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics