Individual
MRS. BRANDY BUCKNER DONNELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4595 E HIGHWAY 20, NICEVILLE, FL 32578-8847
(850) 460-3598
Mailing address
74 LORENZ DR, DEFUNIAK SPRINGS, FL 32435-6640
(850) 699-2509
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OT6212
FL
Other
Enumeration date
07/29/2024
Last updated
07/29/2024
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