| NPI | 1730682782 |
|---|---|
| Former Name | BRONNA RENEE BEADLES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: KS 17-00612) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: MO 2013023270) |
| Enumeration Date | 2018-03-15 |
| Last Update Date | 2018-03-15 |