Individual
BREENA RAE BRNCICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTD, OTR/L
Contact information
Practice address
3002 E DIVISION ST, DIAMOND, IL 60416-9486
(815) 390-5366
Mailing address
27425 S WILL RD, WILMINGTON, IL 60481-8352
(815) 693-9612
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
056.016146
IL
Other
Enumeration date
08/12/2024
Last updated
08/12/2024
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