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General NPI Number Information
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NPI Number | 1578063822
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Entity Type | Individual
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Provider Name | BRIANA ELIZABETH DANNECKER OTR/L
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Gender | Female
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Dates
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Enumeration Date | 02/13/2018
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Last Update Date | 11/18/2022
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Provider Practice Location Address
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Address Line | 14410 METROPOLIS AVE
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City | FORT MYERS
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State | FL
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Zip | 33912-4341
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Country | US
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Telephone | 239-561-2778
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Fax | 239-561-8107
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Provider Business Mailing Address
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Address Line | 23271 MARSH LANDING BLVD
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City | ESTERO
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State | FL
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Zip | 33928-4387
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Country | US
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Telephone | 941-830-4773
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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 | 18977
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License Number State | FL
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