Provider Demographics
NPI:1982755930
Name:BENNETT, ALLISON MARIE (MS OTR-L)
Entity Type:Individual
Prefix:MISS
First Name:ALLISON
Middle Name:MARIE
Last Name:BENNETT
Suffix:
Gender:F
Credentials:MS OTR-L
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1123 BRISBANE WOODS WAY
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27511-9279
Mailing Address - Country:US
Mailing Address - Phone:919-451-2306
Mailing Address - Fax:919-363-5346
Practice Address - Street 1:1031 W WILLIAMS ST
Practice Address - Street 2:SUITE 104
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27502-3955
Practice Address - Country:US
Practice Address - Phone:919-363-5000
Practice Address - Fax:919-363-5346
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5261225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7301667Medicaid
NC14327OtherBLUE CROSS BLUE SHIELD