Provider Demographics
NPI:1861166209
Name:ELDER, BRANDI (OTR)
Entity type:Individual
Prefix:
First Name:BRANDI
Middle Name:
Last Name:ELDER
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3880 ROSELAWN DR
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76207-2306
Mailing Address - Country:US
Mailing Address - Phone:405-620-1876
Mailing Address - Fax:
Practice Address - Street 1:1255 W 15TH ST STE 1025
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-7253
Practice Address - Country:US
Practice Address - Phone:972-673-0404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-08
Last Update Date:2021-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist