NPI 1093279432

Dana Bennett, COTAL

Practitioner Occupational Therapy Assistant Belleville, IL

Practice location

Address: 4500 Memorial Dr, Belleville, IL 62226-5360
Phone: (618) 257-5758

Registered specialties

Occupational Therapy Assistant Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 224Z00000X Licence 057.003529 (IL)

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Registry record

NPI: 1093279432
Entity type: Individual
Sex (as registered): Female
NPI issued: 30 Jan 2019
Record last updated: 30 Jan 2019

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.