Brake, Constance Marie

Brake, Constance Marie is an individual health care provider with primary practice located at 5415 W Friendly Ave Ste A , Greensboro NC 27410-4255. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist, which is considered as her primary health care specialty. Brake, Constance Marie can be contacted via phone (336) 772-5499.

Contact Information

Primary practice address
5415 W Friendly Ave Ste A Greensboro NC 27410-4255
Phone: (336) 772-5499
Fax: (336) 292-6064
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist 225X00000X 4237 North Carolina

Profile Details

NPI number 1407913627
LBN Legal business name Brake, Constance Marie
Credentials MS OTRL
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 3rd, 2007
Last updated Jul 7th, 2011 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407913627 NPPES
North Carolina Other 13740 BLUE CROSS AND BLUE SHIEL
North Carolina MEDICAID 7301713 BLUE CROSS AND BLUE SHIEL

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