Basic Information
| Provider Information | |||||||||
| NPI: | 1134327323 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BENNETT | ||||||||
| FirstName: | DEBORAH | ||||||||
| MiddleName: | KEY | ||||||||
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| Credential: | OTR/L | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7299 MILL CREEK DR | ||||||||
| Address2: | |||||||||
| City: | DORA | ||||||||
| State: | AL | ||||||||
| PostalCode: | 350622231 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2056483641 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2204 LAKESHORE DR | ||||||||
| Address2: | |||||||||
| City: | HOMEWOOD | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352096729 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2058680147 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/10/2007 | ||||||||
| LastUpdateDate: | 07/10/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 631 | AL | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.