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General NPI Number Information
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NPI Number | 1528570330
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Entity Type | Individual
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Provider Name | BRANDI KATHLEEN GONZALES S/OT
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Gender | Female
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Dates
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Enumeration Date | 11/02/2017
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Last Update Date | 12/01/2021
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Provider Practice Location Address
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Address Line | 1918 N MAIN ST
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City | FINDLAY
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State | OH
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Zip | 45840-3818
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Country | US
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Telephone | 512-663-0676
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Fax |
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Provider Business Mailing Address
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Address Line | 430 3 MEADOWS CT
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City | PERRYSBURG
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State | OH
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Zip | 43551-5505
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 210071
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License Number State | TX
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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 |
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License Number State |
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