Provider Demographics
NPI:1194255265
Name:OLDEN, BREANNA THANH (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:BREANNA
Middle Name:THANH
Last Name:OLDEN
Suffix:
Gender:
Credentials:OTR/L
Other - Prefix:MS
Other - First Name:BREANNA
Other - Middle Name:THANH
Other - Last Name:LANDRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1265 SGT JON STILES DR UNIT D
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80129-2266
Mailing Address - Country:US
Mailing Address - Phone:303-274-7332
Mailing Address - Fax:720-497-6733
Practice Address - Street 1:1265 SGT JON STILES DR UNIT D
Practice Address - Street 2:
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80129-2266
Practice Address - Country:US
Practice Address - Phone:303-274-7332
Practice Address - Fax:720-497-6733
Is Sole Proprietor?:No
Enumeration Date:2017-06-12
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIOT-1652225X00000X
COOT.0005994225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist