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General NPI Number Information
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NPI Number | 1881078814
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Entity Type | Individual
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Provider Name | BRIANNE KEEBLER OTD, OTR/L
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Gender | Female
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Dates
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Enumeration Date | 07/20/2015
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Last Update Date | 04/16/2021
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Provider Practice Location Address
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Address Line | 2250 28TH ST SW
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City | WYOMING
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State | MI
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Zip | 49519-2306
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Country | US
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Telephone | 616-379-9887
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Fax |
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Provider Business Mailing Address
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Address Line | 1725 WALKER AVE NW
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City | GRAND RAPIDS
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State | MI
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Zip | 49504-2652
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Country | US
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Telephone | 503-957-6792
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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 | 5201010085
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License Number State | MI
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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 | 330305
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License Number State | OR
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