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NPI 1093672198

NPI 1093672198 : BREANNA MARIE PUTNAM OTD, OTR/L : EFFINGHAM, SC

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General NPI Number Information
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    NPI Number           |    1093672198
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    Entity Type          |    Individual 
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    Provider Name        |    BREANNA MARIE PUTNAM OTD, OTR/L
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    01/08/2026
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    Last Update Date     |    01/08/2026
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Provider Practice Location Address
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    Address Line         |    3007 RED BERRY CIR 
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    City                 |    EFFINGHAM
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    State                |    SC
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    Zip                  |    29541-4944
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    Country              |    US
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    Telephone            |    859-550-6194
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    3007 RED BERRY CIR 
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    City                 |    EFFINGHAM
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    State                |    SC
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    Zip                  |    29541-4944
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    Country              |    US
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    Telephone            |    859-550-6194
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    225X00000X
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    Taxonomy Name        |    Occupational Therapist
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    License Number       |    7340
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    License Number State |    SC
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