Individual
BREANNA SUSTAYTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
3900 GARFIELD AVE, CARMICHAEL, CA 95608-6647
(626) 224-4288
Mailing address
161 W ELVERTA RD UNIT 1238, ELVERTA, CA 95626-4049
(626) 224-4288
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
CA
Other
Enumeration date
03/24/2022
Last updated
03/24/2022
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