Provider Demographics
NPI:1710290283
Name:HOWARD, BRENDA S (OT)
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:S
Last Name:HOWARD
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:9002 N MERIDIAN ST
Mailing Address - Street 2:#222
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-5381
Mailing Address - Country:US
Mailing Address - Phone:317-573-4370
Mailing Address - Fax:317-819-0044
Practice Address - Street 1:6640 PARKDALE PL
Practice Address - Street 2:SUITE O
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46254-5619
Practice Address - Country:US
Practice Address - Phone:317-573-4370
Practice Address - Fax:317-819-0044
Is Sole Proprietor?:No
Enumeration Date:2010-07-26
Last Update Date:2010-07-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN31000031A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist