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Individual

BRANDY ARCHIE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR

Contact information

Practice address
1126 QUEENS PL, KANSAS CITY, MO 64131-3264
(816) 301-5170
(816) 929-6321
Mailing address
1126 QUEENS PL, KANSAS CITY, MO 64131-3264
(816) 301-5170
(816) 929-6321

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2009008897
MO
225XE0001X
Environmental Modification Occupational Therapist
2009008897
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2009008897
OT LICENSE #
MO
Enumeration date
05/13/2016
Last updated
09/09/2020
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