Provider Demographics
NPI:1063856003
Name:REAGAN, ABBY O'BRIEN (OTR/L)
Entity Type:Individual
Prefix:
First Name:ABBY
Middle Name:O'BRIEN
Last Name:REAGAN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5150 BELLEVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:BLUE ASH
Mailing Address - State:OH
Mailing Address - Zip Code:45242-7418
Mailing Address - Country:US
Mailing Address - Phone:513-680-2685
Mailing Address - Fax:
Practice Address - Street 1:5150 BELLEVIEW AVE
Practice Address - Street 2:
Practice Address - City:BLUE ASH
Practice Address - State:OH
Practice Address - Zip Code:45242-7418
Practice Address - Country:US
Practice Address - Phone:513-680-2685
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-22
Last Update Date:2013-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist