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General NPI Number Information
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NPI Number | 1972334472
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Entity Type | Individual
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Provider Name | BRIANNA CORREIA OTD, OTR
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Gender | Female
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Dates
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Enumeration Date | 08/08/2024
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Last Update Date | 08/08/2024
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Provider Practice Location Address
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Address Line | 10127 MOROCCO ST STE 202
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City | SAN ANTONIO
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State | TX
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Zip | 78216-3938
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Country | US
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Telephone | 210-838-5351
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Fax |
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Provider Business Mailing Address
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Address Line | 460 BASTROP HWY S APT 723
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City | AUSTIN
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State | TX
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Zip | 78741-4329
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Country | US
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Telephone | 503-807-2966
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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 | 124787
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License Number State | TX
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