Individual
BRANDY S MCKEOWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L, CLT-LANA
Contact information
Practice address
808 WARD ST W, DOUGLAS, GA 31533-3514
(912) 383-0559
(912) 383-0614
Mailing address
PO BOX 2150, TIFTON, GA 31793-2150
(912) 383-0559
(912) 383-0614
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT 003246
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
624055411A
—
GA
05
—
624055411B
—
GA
Enumeration date
08/01/2006
Last updated
09/07/2010
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