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General NPI Number Information
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NPI Number | 1881376192
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Entity Type | Individual
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Provider Name | BRANDI L BURTON OTR/L
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Gender | Female
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Dates
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Enumeration Date | 08/04/2023
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Last Update Date | 08/04/2023
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Provider Practice Location Address
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Address Line | 17200 W OUTER DR
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City | DEARBORN HEIGHTS
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State | MI
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Zip | 48127-2457
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Country | US
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Telephone | 313-278-4601
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Fax |
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Provider Business Mailing Address
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Address Line | 9428 BYROMAR LN
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City | GROSSE ILE
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State | MI
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Zip | 48138-1206
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Country | US
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Telephone | 970-676-4288
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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 | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 5201013558
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License Number State | MI
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