Most Relevant Information
Provider Data
| NPI Number: | 1003663626 |
| Provider Name: | PAGE KENNEDY BETTENCOURT OTR/L |
| Entity Type: | Individual |
| Taxonomy Code: | 225XP0200X |
| Specialty: | Occupational Therapist |
| License Number: |
Most Important Dates
| Enumeration Date: | 05/01/2024 |
| Last Updated: | 05/01/2024 |
Provider Practice Location
49 MOUNT WHITNEY DR
SAN RAFAEL
CA
949031036
Practice Location Phone/Fax
| Phone: | 4086668569 |
| Fax: |
Provider Mailing Location
49 MOUNT WHITNEY DR
SAN RAFAEL
CA
949031036
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |