MEDICARE: GABRIELLE BRANT

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	225X00000X	Occupational Therapist	OTP-OT-LIC-11641	MT

General Provider Information

NPI Number	:	1659185312
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GABRIELLE BRANT

Provider Business Mailing Address
First Line	:	1650 LYNDON FARM CT STE 300
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40223-5005
Country	:	US
Telephone Number	:	726-202-3039
Fax Number	:

Provider Business Practice Location Address
First Line	:	1741 GRAND AVE
Second Line	:
City	:	BILLINGS
State	:	MT
Zip	:	59102-2937
Country	:	US
Telephone Number	:	406-969-6610
Fax Number	:

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

Provider Enumeration Date	:	02/04/2025
Last Update Date	:	02/04/2025

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Directions to “ GABRIELLE BRANT ” Practice Location

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