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General NPI Number Information
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NPI Number | 1104501832
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Entity Type | Individual
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Provider Name | BRIGETTE ELKINS OTR/L
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Gender | Female
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Dates
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Enumeration Date | 06/20/2023
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Last Update Date | 06/20/2023
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Provider Practice Location Address
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Address Line | 2407 STOUT RD
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City | MENOMONIE
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State | WI
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Zip | 54751-2344
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Country | US
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Telephone | 715-233-7740
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Fax |
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Provider Business Mailing Address
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Address Line | 3029 WALLACE DR
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City | SHREVEPORT
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State | LA
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Zip | 71119-3303
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Country | US
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Telephone | 318-237-3411
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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 | 8313-26
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License Number State | WI
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