Provider Demographics
NPI:1164796355
Name:BRENNAN, ANDREA FAYE (OTR/L)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:FAYE
Last Name:BRENNAN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:FAYE
Other - Last Name:WERBEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OTR/L
Mailing Address - Street 1:10748 E HOPE DR
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85259-3840
Mailing Address - Country:US
Mailing Address - Phone:480-391-2243
Mailing Address - Fax:480-391-2243
Practice Address - Street 1:10748 E HOPE DR
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85259-3840
Practice Address - Country:US
Practice Address - Phone:480-391-2243
Practice Address - Fax:480-391-2243
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-06
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ55225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation