Provider Demographics
NPI:1134469513
Name:BRENDE, MARILYN BELL (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:MARILYN
Middle Name:BELL
Last Name:BRENDE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1427 T ST
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95501-2577
Mailing Address - Country:US
Mailing Address - Phone:707-362-1045
Mailing Address - Fax:
Practice Address - Street 1:1427 T ST
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95501-2577
Practice Address - Country:US
Practice Address - Phone:707-362-1045
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-22
Last Update Date:2013-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3785174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist