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General NPI Number Information
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NPI Number | 1871125088
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Entity Type | Organization
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Legal Business Name | AMY BRACKEN, PLLC
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Dates
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Enumeration Date | 02/05/2020
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Last Update Date | 02/05/2020
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Provider Practice Location Address
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Address Line | 212 S HILLANDALE DR
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City | EAST FLAT ROCK
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State | NC
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Zip | 28726-2610
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Country | US
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Telephone | 828-337-3553
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Fax | 855-764-0273
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Provider Business Mailing Address
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Address Line | 212 S HILLANDALE DR
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City | EAST FLAT ROCK
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State | NC
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Zip | 28726-2610
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Country | US
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Telephone | 828-337-3553
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Fax | 855-764-0273
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | AMY BRACKEN
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Credential | MOTR/L
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Telephone | 828-337-3553
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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 |
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License Number State |
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