Provider Demographics
NPI:1093096539
Name:DUVALL, BRANDI LYNN (MS, OTR/L)
Entity Type:Individual
Prefix:
First Name:BRANDI
Middle Name:LYNN
Last Name:DUVALL
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9165 VANDUSEN RD
Mailing Address - Street 2:
Mailing Address - City:HOUGHTON
Mailing Address - State:NY
Mailing Address - Zip Code:14744-8759
Mailing Address - Country:US
Mailing Address - Phone:585-260-8673
Mailing Address - Fax:
Practice Address - Street 1:11390 TRANSIT RD
Practice Address - Street 2:
Practice Address - City:EAST AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14051-1017
Practice Address - Country:US
Practice Address - Phone:716-580-3040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-29
Last Update Date:2012-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017235225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics