Individual
BRANDY NICOLE MAINORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
315 OLYPMIC CT UNIT B, STATELINE, NV 89449-8944
(916) 759-7986
Mailing address
PO BOX 4242, STATELINE, NV 89449-4242
(916) 759-7986
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
17-0862
NV
Other
Enumeration date
08/25/2017
Last updated
08/25/2017
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