Individual
MELISSA BRANNAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
3918 PECAN GROVE RD, RUDY, AR 72952-9026
(479) 632-6337
(479) 632-5916
Mailing address
3918 PECAN GROVE RD, RUDY, AR 72952-9026
(479) 632-6337
(479) 632-5916
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA1033
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OTA1033
STATE LICENSE
AR
Enumeration date
02/02/2016
Last updated
02/02/2016
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