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General NPI Number Information
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NPI Number | 1538718804
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Entity Type | Individual
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Provider Name | BRIANNA CHRISTINE DEGROAT MM, MT-BC
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Gender | Female
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Dates
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Enumeration Date | 09/09/2019
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Last Update Date | 02/02/2023
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Provider Practice Location Address
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Address Line | 2980 WILLIAM ST
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City | CHEEKTOWAGA
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State | NY
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Zip | 14227-1918
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Country | US
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Telephone | 716-892-2060
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Fax |
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Provider Business Mailing Address
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Address Line | 6693 HAMILTON DR UNIT LT
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City | DERBY
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State | NY
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Zip | 14047-9667
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Country | US
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Telephone | 716-472-2298
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #3
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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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Taxonomy #4
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 225A00000X
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Taxonomy Name | Music Therapist
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License Number |
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License Number State |
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