Brandon Bracy, COTA/L
Individual provider Active NPI Occupational Therapy Assistant · Avondale, AZ
NPI 1801427596 · NPPES record last updated Jan 31, 2020
Key facts
- NPI
- 1801427596
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapy Assistant 224Z00000X
- License
- 5089 (AZ)
- Practice address
- 350 E la Canada Blvd
Avondale, AZ 85323-1643 - Phone
- (623) 932-2282
- NPI assigned
- Jan 31, 2020
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|
| 5089 | AZ | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 5089 | AZ | Yes |
Addresses
Primary practice location
350 E la Canada Blvd
Avondale, AZ 85323-1643
Mailing address
19443 W Morning Glory Dr
Buckeye, AZ 85326-5810
Phone (330) 573-9566
Other providers in Avondale, AZ
- Jocelyn Constance Bouchard
- Joyce Akosua Bour
- Mathieu Bourassa
- Brandon Bowman
- Kyla Boyd
- Alexia Bradshaw
- Braida Bradshaw
- Amanda Bramlett
- Stephanie Brandt
- Sonja Braswell
All providers in Avondale, AZ · Occupational Therapy Assistant in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 31, 2020. 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.