Provider Demographics
NPI:1083732259
Name:TOBIN, BRANDI DIANE (OTR)
Entity Type:Individual
Prefix:
First Name:BRANDI
Middle Name:DIANE
Last Name:TOBIN
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:902 SOM CENTER RD APT 104
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44143-3569
Mailing Address - Country:US
Mailing Address - Phone:440-665-3238
Mailing Address - Fax:
Practice Address - Street 1:3 MERIT DR.
Practice Address - Street 2:
Practice Address - City:RICHMOND HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44143-1456
Practice Address - Country:US
Practice Address - Phone:216-261-9600
Practice Address - Fax:216-261-9662
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT5925225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist