Provider Demographics
NPI:1306044201
Name:WEBSTER, BRANDI RENEE (OTRL)
Entity Type:Individual
Prefix:MISS
First Name:BRANDI
Middle Name:RENEE
Last Name:WEBSTER
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4000 BAR HARBOR CIR
Mailing Address - Street 2:
Mailing Address - City:YUKON
Mailing Address - State:OK
Mailing Address - Zip Code:73099-3255
Mailing Address - Country:US
Mailing Address - Phone:405-354-6422
Mailing Address - Fax:
Practice Address - Street 1:4000 BAR HARBOR CIR
Practice Address - Street 2:
Practice Address - City:YUKON
Practice Address - State:OK
Practice Address - Zip Code:73099-3255
Practice Address - Country:US
Practice Address - Phone:405-354-6422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK964225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist