Individual
KRISTIN BRUNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3657 LONGBOW RD, COCOA, FL 32926-4442
(321) 877-8590
Mailing address
3657 LONGBOW RD, COCOA, FL 32926-4442
(321) 877-8590
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
OTA9712
FL
225X00000X
Occupational Therapist
Primary
OT21708
FL
390200000X
Student in an Organized Health Care Education/Training Program
OTA9712
FL
Other
Enumeration date
01/27/2017
Last updated
06/17/2021
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