Provider Demographics
NPI:1457826562
Name:QUINNEY, BRIANNA (OTR)
Entity Type:Individual
Prefix:
First Name:BRIANNA
Middle Name:
Last Name:QUINNEY
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 148
Mailing Address - Street 2:
Mailing Address - City:SHERIDAN
Mailing Address - State:TX
Mailing Address - Zip Code:77475-0148
Mailing Address - Country:US
Mailing Address - Phone:979-561-6836
Mailing Address - Fax:
Practice Address - Street 1:535 S AUSTIN RD
Practice Address - Street 2:
Practice Address - City:EAGLE LAKE
Practice Address - State:TX
Practice Address - Zip Code:77434-3001
Practice Address - Country:US
Practice Address - Phone:979-234-3910
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-04
Last Update Date:2018-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX116689225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist