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Individual

GLORIA D BRICKENDEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.A., OTR/L

Contact information

Practice address
2736 HOLLYWOOD BLVD, HOLLYWOOD, FL 33020-4808
(954) 603-1881
Mailing address
2736 HOLLYWOOD BLVD, HOLLYWOOD, FL 33020-4808
(954) 603-1881

Taxonomy

Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT8580
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
884789400
FL
Enumeration date
01/26/2007
Last updated
10/28/2021
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