Individual
DORENE BRANTLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1603 COURT ST, SYRACUSE, NY 13208-1834
(315) 455-7591
(315) 455-2446
Mailing address
PO BOX 2000, ENROLLMENT DEPT, EAST SYRACUSE, NY 13057-4500
(315) 362-5129
(315) 362-5179
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
002433
NY
Other
Enumeration date
05/22/2009
Last updated
05/22/2009
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