Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OT.0001394 | CO |
N | 225XE0001X | Environmental Modification | ||
N | 225XG0600X | Occupational Therapist - Gerontology | OT.0001394 | CO |
NPI | 1154820488 |
---|---|
Provider Name | Brandy Bregar |
First Address | Pueblo, CO 81008-2610 |
Second Address | Pueblo, CO 81008-2610 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2018 |
Last Update Date | 16/01/2020 |