Individual ProviderAmanda BensonOccupational TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address4509 Clingman Dr, Shreveport, LA 71105-3211(318) 540-8180PECOS EnrollmentBased on the most recent information from CMS, provider Amanda Benson does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1033591771Provider TypeIndividualFull NameBenson, AmandaCredentialLOTRGenderFemaleSole ProprietorYesEnumeration Date6/18/2015Last Updated6/18/2015Contact InformationPractice LocationPractice Address4509 Clingman Dr, Shreveport, LA 71105-3211Phone(318) 540-8180FaxUnlisted FaxMailing LocationMailing Address4509 Clingman Dr, Shreveport, LA 71105Phone(318) 540-8180FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode225X00000XPrimaryDescriptionOccupational TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicenseOTT.200191Louisiana