Provider Demographics
NPI:1881025757
Name:BRUMANT, CLAUDETTE
Entity Type:Individual
Prefix:
First Name:CLAUDETTE
Middle Name:
Last Name:BRUMANT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CLAUDETTE
Other - Middle Name:
Other - Last Name:BRUMANT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSOTR
Mailing Address - Street 1:3071 MONTAUK HILL DR
Mailing Address - Street 2:
Mailing Address - City:BUFORD
Mailing Address - State:GA
Mailing Address - Zip Code:30519-8619
Mailing Address - Country:US
Mailing Address - Phone:646-305-4762
Mailing Address - Fax:
Practice Address - Street 1:4500 SATELLITE BLVD
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096
Practice Address - Country:US
Practice Address - Phone:646-305-4762
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-03
Last Update Date:2016-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00460800225X00000X
GAOT004754225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist