| NPI | 1699704296 |
|---|---|
| Former Name | MICHELLE LYNN BRUNNER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: WI 3629) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 056006611) |
| 225100000X Physical Therapist (Licence: WI 3629026) | |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2017-12-04 |