Bennett, Autumn
Bennett, Autumn is an individual health care provider with primary practice located at 151 Southwest Dr , Jonesboro AR 72401-5828. She recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist is her primary health care specialty. Bennett, Autumn can be contacted via phone (870) 932-0090.Contact Information
Primary practice address
151 Southwest Dr
Jonesboro AR 72401-5828
Phone: (870) 932-0090
Fax: (870) 930-9336
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant | 225200000X | PTA 2244 | Arkansas |
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist | 225X00000X | OTR2670 | Arkansas |
Profile Details
| NPI number | 1548580590 |
|---|---|
| LBN Legal business name | Bennett, Autumn |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 1st, 2010 |
| Last updated | Jan 21st, 2014 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1548580590 | NPPES |
| Arkansas | MEDICAID | 186051721 |
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