Provider Demographics
NPI:1235783192
Name:DELANO, BRENDA (OTD, OTR/L)
Entity Type:Individual
Prefix:DR
First Name:BRENDA
Middle Name:
Last Name:DELANO
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:MS
Other - First Name:BRENDA
Other - Middle Name:
Other - Last Name:PANKOKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:317 N NORBECK ST APT 112
Mailing Address - Street 2:
Mailing Address - City:VERMILLION
Mailing Address - State:SD
Mailing Address - Zip Code:57069-2854
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:410 BALL PARK RD
Practice Address - Street 2:
Practice Address - City:PONCA
Practice Address - State:NE
Practice Address - Zip Code:68770-7243
Practice Address - Country:US
Practice Address - Phone:402-380-6529
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-30
Last Update Date:2019-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist