Provider Demographics
NPI:1689727638
Name:LARDEAR, ANNE BREDEN (OTR)
Entity Type:Individual
Prefix:MRS
First Name:ANNE
Middle Name:BREDEN
Last Name:LARDEAR
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 1:2602 DEEPWOOD DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19810-3502
Mailing Address - Country:US
Mailing Address - Phone:302-478-7022
Mailing Address - Fax:
Practice Address - Street 1:2602 DEEPWOOD DR
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810-3502
Practice Address - Country:US
Practice Address - Phone:302-478-7022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEU1-0000137225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist