Provider Demographics
NPI:1730262908
Name:BRANDT, JOANN M (MOT,OTR/L)
Entity type:Individual
Prefix:MRS
First Name:JOANN
Middle Name:M
Last Name:BRANDT
Suffix:
Gender:F
Credentials:MOT,OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3701 NE 22ND AVE
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34479-2562
Mailing Address - Country:US
Mailing Address - Phone:352-671-1429
Mailing Address - Fax:
Practice Address - Street 1:2102 SW 20TH PL STE 500
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474-7060
Practice Address - Country:US
Practice Address - Phone:352-873-7247
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL8630174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist