Provider Demographics
NPI:1457910747
Name:SANDERS, BRITTNEY DANIELLE (MOT, OTR/L)
Entity Type:Individual
Prefix:
First Name:BRITTNEY
Middle Name:DANIELLE
Last Name:SANDERS
Suffix:
Gender:F
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 JOST MANOR DR
Mailing Address - Street 2:
Mailing Address - City:FLORISSANT
Mailing Address - State:MO
Mailing Address - Zip Code:63034-2268
Mailing Address - Country:US
Mailing Address - Phone:314-322-1763
Mailing Address - Fax:
Practice Address - Street 1:2963 DODDRIDGE AVE
Practice Address - Street 2:
Practice Address - City:MARYLAND HEIGHTS
Practice Address - State:MO
Practice Address - Zip Code:63043-1736
Practice Address - Country:US
Practice Address - Phone:314-291-4557
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-10
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2019001237225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist