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General NPI Number Information
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NPI Number | 1720488232
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Entity Type | Individual
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Provider Name | BRYNNE BASYE
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Gender | Female
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Dates
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Enumeration Date | 09/03/2014
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Last Update Date | 10/24/2019
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Provider Practice Location Address
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Address Line | 155 PRINTERS PKWY STE 100
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City | COLORADO SPRINGS
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State | CO
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Zip | 80910-6101
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Country | US
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Telephone | 719-597-0822
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Fax |
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Provider Business Mailing Address
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Address Line | 4258 LITTLE ROCK VW
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City | COLORADO SPRINGS
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State | CO
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Zip | 80911-3197
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Country | US
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Telephone | 785-639-2852
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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 | OTA.0000551
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License Number State | CO
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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 | OT.0006220
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License Number State | CO
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