Provider Demographics
NPI:1811264211
Name:BENTZEN, ANNE HOUSTON (OT)
Entity type:Individual
Prefix:MRS
First Name:ANNE
Middle Name:HOUSTON
Last Name:BENTZEN
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 1:3 PHEASANT DRIVE
Mailing Address - Street 2:
Mailing Address - City:ARMONK
Mailing Address - State:NY
Mailing Address - Zip Code:10504-1321
Mailing Address - Country:US
Mailing Address - Phone:914-588-4079
Mailing Address - Fax:914-273-8461
Practice Address - Street 1:3 PHEASANT DR
Practice Address - Street 2:
Practice Address - City:ARMONK
Practice Address - State:NY
Practice Address - Zip Code:10504-1321
Practice Address - Country:US
Practice Address - Phone:914-588-4079
Practice Address - Fax:914-273-8461
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-30
Last Update Date:2011-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001811225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist