Provider Demographics
NPI:1659519882
Name:TWIBELL, BRYNN CAROLYN (RTC)
Entity Type:Individual
Prefix:MISS
First Name:BRYNN
Middle Name:CAROLYN
Last Name:TWIBELL
Suffix:
Gender:F
Credentials:RTC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9261 FOLSOM BLVD
Mailing Address - Street 2:SUITE 500
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95826-2561
Mailing Address - Country:US
Mailing Address - Phone:916-363-1403
Mailing Address - Fax:
Practice Address - Street 1:9261 FOLSOM BLVD
Practice Address - Street 2:SUITE 500
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95826-2561
Practice Address - Country:US
Practice Address - Phone:916-363-1553
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-26
Last Update Date:2009-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA4097-T225800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist