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Individual

BRANDI M THORWARTH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
2420 WILSON AVE, MADISON, IN 47250-2135
(501) 802-5479
Mailing address
10223 E STATE ROAD 156, VEVAY, IN 47043-2837
(501) 802-5479

Taxonomy

Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
31007908A
IN
225XP0200X
Pediatric Occupational Therapist
OTR1461
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
136478721
AR
Enumeration date
06/04/2010
Last updated
08/15/2023
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