Provider Demographics
NPI:1730806027
Name:BRAND, SYDNEY ELISE
Entity type:Individual
Prefix:
First Name:SYDNEY
Middle Name:ELISE
Last Name:BRAND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1015 NEVILLE ST
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72401-4837
Mailing Address - Country:US
Mailing Address - Phone:501-516-3658
Mailing Address - Fax:
Practice Address - Street 1:1015 NEVILLE ST
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-4837
Practice Address - Country:US
Practice Address - Phone:501-516-3658
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-26
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant