NPI 1164439691 · live from the CMS NPI Registry
S. Brian Bennett, OT
Occupational Therapist in Provo, UT. National Provider Identifier 1164439691, active.
NPI record
| NPI | 1164439691 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Occupational Therapist 225X00000X |
| Practice location | 1034 N 500 W, Provo, UT 84604 |
| Practice phone | 801-357-7475 |
| Mailing address | Po Box 25537, Salt Lake City, UT 84125 |
| Enumerated | August 1, 2006 |
| Last updated | April 30, 2026 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Occupational Therapist primary | 225X00000X | 5110123-4201 (UT) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.