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Individual

MRS. CRYSTAL MARIE BRYNILDSEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS OTR/L

Contact information

Practice address
2409 LEVANTE ST, CARLSBAD, CA 92009-8020
(607) 222-4074
Mailing address
4736 ROUTE 467, ROME, PA 18837-7969
(607) 222-4074

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
10264
CA
225X00000X
Occupational Therapist
46TR00439600
NJ

Other

Enumeration date
08/27/2012
Last updated
07/21/2013
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