Provider Demographics
NPI:1568761369
Name:SENNETT, BRENDA KAY (COTA/L)
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:KAY
Last Name:SENNETT
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9801 SOUTH 23RD STREET
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:NE
Mailing Address - Zip Code:68123
Mailing Address - Country:US
Mailing Address - Phone:402-934-9380
Mailing Address - Fax:
Practice Address - Street 1:1600 MCPHERSON AVENUE
Practice Address - Street 2:
Practice Address - City:COUNCIL BLUFFS
Practice Address - State:IA
Practice Address - Zip Code:51503
Practice Address - Country:US
Practice Address - Phone:712-352-2922
Practice Address - Fax:712-352-2929
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-18
Last Update Date:2011-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA000826225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist