Individual
JILL ANN BRANDABERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
214 W MAIN, PUYALLUP, WA 98371-5328
(253) 841-8700
Mailing address
214 W MAIN, PUYALLUP, WA 98371-5328
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OC60773959
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
OC60773959
—
WA
Enumeration date
12/12/2017
Last updated
12/12/2017
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