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General NPI Number Information
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NPI Number | 1942105945
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Entity Type | Individual
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Provider Name | MARY GRACE BRANDT
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Gender | Female
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Dates
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Enumeration Date | 10/09/2026
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Last Update Date | 10/09/2026
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Provider Practice Location Address
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Address Line | 3416 KILLARNEY CT
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City | LAPORTE
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State | CO
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Zip | 80535-9337
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Country | US
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Telephone | 720-310-8196
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Fax |
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Provider Business Mailing Address
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Address Line | 2525 ELIOT ST APT 205
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City | DENVER
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State | CO
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Zip | 80211-4867
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Country | US
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Telephone | 216-905-0482
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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 |
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License Number State | NULL
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