Individual
LACEY AMBER BRELAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
7970 BELLINGRATH RD, THEODORE, AL 36582
(601) 270-9667
Mailing address
7970 BELLINGRATH RD, THEODORE, AL 36582-2763
(601) 270-9667
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
3232
AL
Other
Enumeration date
08/16/2012
Last updated
08/16/2012
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