Provider Demographics
NPI:1881361780
Name:SNIDER, BRIANNE N (OTR/L)
Entity type:Individual
Prefix:
First Name:BRIANNE
Middle Name:N
Last Name:SNIDER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1385 W UNIVERSITY AVE UNIT 217
Mailing Address - Street 2:
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86001-7139
Mailing Address - Country:US
Mailing Address - Phone:863-325-5399
Mailing Address - Fax:
Practice Address - Street 1:1016 W UNIVERSITY AVE UNIT 220
Practice Address - Street 2:
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86001-2997
Practice Address - Country:US
Practice Address - Phone:863-325-5399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-27
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI8462225X00000X
AZ225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist