Healthcare Provider Details

I. General information

NPI: 1033619457
Provider Name (Legal Business Name): ROSE MARIE BRENNER OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2018
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3535 13TH AVE S
MINNEAPOLIS MN
55407-2220
US

IV. Provider business mailing address

1616 N WASHINGTON ST
DENVER CO
80203-1451
US

V. Phone/Fax

Practice location:
  • Phone: 920-428-8715
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: