Brayton, Mary R
Brayton, Mary R is an individual health care provider with primary practice located at 112 E 5Th Ave , Antigo WI 54409-2710. 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. Brayton, Mary R can be contacted via phone (715) 623-9469.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist | 225X00000X | 1737-026 | Wisconsin |
Profile Details
| NPI number | 1659497089 |
|---|---|
| LBN Legal business name | Brayton, Mary R |
| Credentials | MS, OTR |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 21st, 2007 |
| Last updated | Jul 9th, 2007 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1659497089 | NPPES |
| Wisconsin | MEDICAID | 40611300 | |
| Wisconsin | Other | 1737-026 |
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