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Individual

MRS. BRENDA DIANE BREITBACH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
1115 4TH AVE N, SAUK RAPIDS, MN 56379-2201
(320) 258-8662
(320) 258-9752
Mailing address
1115 4TH AVE N, SAUK RAPIDS, MN 56379-2201
(320) 258-8662
(320) 258-9752

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
103067
MN

Other

Enumeration date
09/01/2015
Last updated
09/01/2015
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