Provider Demographics
NPI:1427324151
Name:BENNINGFIELD, CHRISTINA L (OT)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:L
Last Name:BENNINGFIELD
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 35
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:KY
Mailing Address - Zip Code:42728-0035
Mailing Address - Country:US
Mailing Address - Phone:270-403-8015
Mailing Address - Fax:
Practice Address - Street 1:102 CATHEDRAL MNR
Practice Address - Street 2:D
Practice Address - City:BARDSTOWN
Practice Address - State:KY
Practice Address - Zip Code:40004-1253
Practice Address - Country:US
Practice Address - Phone:502-640-4554
Practice Address - Fax:502-640-4554
Is Sole Proprietor?:No
Enumeration Date:2012-03-27
Last Update Date:2020-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYR4686174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist