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General NPI Number Information
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NPI Number | 1881410868
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Entity Type | Individual
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Provider Name | HENRY BRENNAN OTD, OTR/L
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Gender | Male
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Dates
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Enumeration Date | 11/25/2024
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Last Update Date | 11/25/2024
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Provider Practice Location Address
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Address Line | 1130 W WOODMEN RD
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City | COLORADO SPRINGS
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State | CO
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Zip | 80919-2726
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Country | US
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Telephone | 719-937-8827
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Fax |
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Provider Business Mailing Address
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Address Line | 1103 DANCING HORSE DR
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City | COLORADO SPRINGS
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State | CO
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Zip | 80919-3909
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Country | US
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Telephone | 434-484-0775
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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 | OT.0008083
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License Number State | CO
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