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General NPI Number Information
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NPI Number | 1235783192
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Entity Type | Individual
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Provider Name | BRENDA DELANO OTD, OTR/L
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Gender | Female
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Dates
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Enumeration Date | 07/30/2019
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Last Update Date | 07/30/2019
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Provider Practice Location Address
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Address Line | 410 BALL PARK RD
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City | PONCA
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State | NE
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Zip | 68770-7243
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Country | US
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Telephone | 402-380-6529
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Fax |
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Provider Business Mailing Address
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Address Line | 317 N NORBECK ST APT 112
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City | VERMILLION
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State | SD
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Zip | 57069-2854
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Country | US
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Telephone |
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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 |
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License Number State |
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