Most Relevant Information
Provider Data
| NPI Number: | 1003398090 |
| Provider Name: | JACKIE LYNNE BENSON MOT, OTR/L, CLT |
| Entity Type: | Individual |
| Taxonomy Code: | 225X00000X |
| Specialty: | Occupational Therapist |
| License Number: | 2247 |
Most Important Dates
| Enumeration Date: | 09/05/2018 |
| Last Updated: | 02/22/2021 |
Provider Practice Location
1043 10TH ST
HUMBOLDT
NE
683766018
Practice Location Phone/Fax
| Phone: | 4028622000 |
| Fax: |
Provider Mailing Location
61740 US HIGHWAY 136
TECUMSEH
NE
684508401
Provider Mailing Phone/Fax
| Phone: | 4023357964 |
| Fax: |