Healthcare Provider Details

I. General information

NPI: 1295648640
Provider Name (Legal Business Name): B&R THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2026
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

141 S MCCORMICK ST STE 103
PRESCOTT AZ
86303-4730
US

IV. Provider business mailing address

515 W HILLSIDE AVE
PRESCOTT AZ
86301-1924
US

V. Phone/Fax

Practice location:
  • Phone: 701-205-1440
  • Fax:
Mailing address:
  • Phone: 701-205-1440
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: BETH ROSSI
Title or Position: ADMINISTRATOR
Credential:
Phone: 701-205-1440