Individual
BREANNA PROPHETE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, OTR/L
Contact information
Practice address
8212 151ST AVE, JAMAICA, NY 11414-1793
(718) 848-0300
Mailing address
10707 165TH ST, JAMAICA, NY 11433-2406
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
027922-01
NY
Other
Enumeration date
06/15/2023
Last updated
06/15/2023
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