Individual
BREANNE K GREENOUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10431 STATE ROUTE 22, GRANVILLE, NY 12832-5027
(518) 538-4107
Mailing address
10431 STATE ROUTE 22, GRANVILLE, NY 12832-5027
(518) 538-4107
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
22-21052
NY
Other
Enumeration date
04/05/2022
Last updated
04/05/2022
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