MEDICARE: DARA REBECCA BRANN OTR/L

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225XP0200X	Pediatric Occupational Therapist	111984	AK

General Provider Information

NPI Number	:	1558501783
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DARA REBECCA BRANN OTR/L

Provider Business Mailing Address
First Line	:	2451 SPRUCEWOOD ST
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99508-3974
Country	:	US
Telephone Number	:	907-378-4833
Fax Number	:

Provider Business Practice Location Address
First Line	:	11901 BUSINESS BLVD
Second Line	:	STE. 209
City	:	EAGLE RIVER
State	:	AK
Zip	:	99577-7701
Country	:	US
Telephone Number	:	907-694-6002
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/27/2009
Last Update Date	:	01/24/2017

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Directions to “ DARA REBECCA BRANN OTR/L” Practice Location

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