Provider Demographics
NPI:1164979712
Name:BRANNAN, JAMES BENSON (COTA/L)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:BENSON
Last Name:BRANNAN
Suffix:
Gender:M
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13364 BIRCH COURT
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80241
Mailing Address - Country:US
Mailing Address - Phone:813-957-5351
Mailing Address - Fax:
Practice Address - Street 1:13364 BIRCH COURT
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80241
Practice Address - Country:US
Practice Address - Phone:813-957-5351
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-01
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0000093224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant