Provider Demographics
NPI:1023419090
Name:BENNETT, WHITNEY NICOLE (MS, OTR/L)
Entity type:Individual
Prefix:MS
First Name:WHITNEY
Middle Name:NICOLE
Last Name:BENNETT
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 1:809 PENSBY CT
Mailing Address - Street 2:
Mailing Address - City:HOLLY SPRINGS
Mailing Address - State:NC
Mailing Address - Zip Code:27540-8788
Mailing Address - Country:US
Mailing Address - Phone:919-434-9322
Mailing Address - Fax:
Practice Address - Street 1:111 N FERN ABBEY LN
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-8981
Practice Address - Country:US
Practice Address - Phone:919-647-4763
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-10
Last Update Date:2018-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9394225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist