Individual
MRS. GRETCHEN ANNE BRUBAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOT, OTR/L, MCIS
Contact information
Practice address
88 JUNIPER ST, HOMER CITY, PA 15748-1507
(724) 915-8176
Mailing address
88 JUNIPER ST, HOMER CITY, PA 15748-1507
(724) 915-8176
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OC012553
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1033318880001
—
PA
Enumeration date
08/14/2017
Last updated
08/14/2017
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