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Individual
JUSTIN BRAZEAL
Active
Individual
JUSTIN BRAZEAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, OTR/L
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTR2546
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
194197721
—
AR
Enumeration date
09/11/2012
Last updated
01/31/2023
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