Individual
BRENDAN SIMARD MCSHANE
Active
Individual
BRENDAN SIMARD MCSHANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
17-02788
KS
225X00000X
Occupational Therapist
Primary
2012005417
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17-02788
KANSAS STATE LICENSE
KS
01
—
2012005417
STATE LICENSE
MO
Enumeration date
11/09/2009
Last updated
08/11/2020
Update your record
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