Tanya Jo Braet, MOT, OTR/L
Individual provider Active NPI Occupational Therapist · Colona, IL
NPI 1295992147 · NPPES record last updated May 19, 2008
Key facts
- NPI
- 1295992147
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- 01771 (IA)
- Practice address
- 5939 Dayton Corner B St
Colona, IL 61241-8924 - Phone
- (309) 792-2426
- NPI assigned
- May 19, 2008
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01771 | IA | MD | Occupational Therapist |
| 056.007833 | IL | MD | Occupational Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 056.007833 | IL | |
| Occupational Therapist | 225X00000X | 01771 | IA | Yes |
Addresses
Primary practice location
5939 Dayton Corner B St
Colona, IL 61241-8924
Mailing address
5939 Dayton Corner B St
Colona, IL 61241-8924
Phone (309) 792-2426
Other providers in Colona, IL
- Barbara Allen
- Douglas John Bull
- Colona School District 190
- David Cook
- East Moline Dental Center PC
- Harry H Fonteyne
All providers in Colona, IL · Occupational Therapist in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 19, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.