Individual
BREAUNA GARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
9300 JOHN HICKMAN PKWY STE 104, FRISCO, TX 75035-5936
(469) 971-3830
Mailing address
1325 PECOS CT, LANCASTER, TX 75146-2900
(469) 971-3830
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
121830
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
121830
LICENSE FOR OT
TX
Enumeration date
09/21/2021
Last updated
09/22/2021
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