Johnson, Brenna Stanley
Johnson, Brenna Stanley is an individual health care provider with primary practice located at 817 N Mound St , Nacogdoches TX 75961. She recently has 3 registered licenses in different health care specialties including Other Service Providers / Specialist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics is her primary health care specialty. Johnson, Brenna Stanley can be contacted via phone (936) 564-6907.Contact Information
Primary practice address
817 N Mound St
Nacogdoches TX 75961
Phone: (936) 564-6907
Fax: (936) 564-0509
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 107063 | Texas |
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist | 225X00000X | ||
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics | 225XP0200X | 107063 | Texas |
Profile Details
| NPI number | 1508874637 |
|---|---|
| LBN Legal business name | Johnson, Brenna Stanley |
| Credentials | Registered Occupational Therapist (OTR) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 4th, 2006 |
| Last updated | Feb 16th, 2023 - about last year |
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 | 1508874637 | NPPES |
| Texas | Other | 659657 | BCBS # |
| Texas | MEDICAID | 1637803-02 | BCBS # |
| Texas | MEDICAID | 1637803-01 | BCBS # |
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