Individual
SAMANTHA BRABENDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8274 E SAN RD, SOUTH RANGE, WI 54874-8621
(715) 398-3523
Mailing address
8274 E SAN RD, SOUTH RANGE, WI 54874-8621
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5299-27
WI
Other
Enumeration date
12/02/2016
Last updated
12/02/2016
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