Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 2015001671 | MO |
NPI | 1023639820 |
---|---|
Provider Name | Dawn Brammer |
First Address | Marceline, MO 64658-1106 |
Second Address | Marceline, MO 64658-1716 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2020 |
Last Update Date | 03/05/2020 |