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General NPI Number Information
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NPI Number | 1437474111
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Entity Type | Individual
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Provider Name | REGINA ANNE LILLY BRASWELL OTR/L
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Gender | Female
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Dates
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Enumeration Date | 04/06/2010
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Last Update Date | 03/13/2025
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Provider Practice Location Address
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Address Line | 908 1ST ST
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City | OZONA
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State | TX
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Zip | 76943
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Country | US
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Telephone | 253-929-8723
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Fax |
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Provider Business Mailing Address
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Address Line | 11546 NORTHCROSS LN
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City | SAN ANGELO
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State | TX
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Zip | 76904-3628
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Country | US
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Telephone | 501-732-6224
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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 | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | OTR2346
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 118742
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License Number State | TX
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