Provider Demographics
NPI:1669123808
Name:HAMLETT, BETHANY (COTA/L)
Entity type:Individual
Prefix:
First Name:BETHANY
Middle Name:
Last Name:HAMLETT
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:PO BOX 10864
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24543-5015
Mailing Address - Country:US
Mailing Address - Phone:434-799-7732
Mailing Address - Fax:434-799-7733
Practice Address - Street 1:159 EXECUTIVE DR STE A
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24541-4160
Practice Address - Country:US
Practice Address - Phone:434-799-7732
Practice Address - Fax:434-799-7733
Is Sole Proprietor?:No
Enumeration Date:2022-01-10
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0131002572224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant