Provider Demographics
NPI:1447934815
Name:HUNLEY, BREANNA F (COTA)
Entity type:Individual
Prefix:
First Name:BREANNA
Middle Name:F
Last Name:HUNLEY
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 RANGER ST APT A
Mailing Address - Street 2:
Mailing Address - City:KINGSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78363-6602
Mailing Address - Country:US
Mailing Address - Phone:931-572-7765
Mailing Address - Fax:
Practice Address - Street 1:103 RANGER ST APT A
Practice Address - Street 2:
Practice Address - City:KINGSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78363-6602
Practice Address - Country:US
Practice Address - Phone:931-572-7765
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-14
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX217764224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant