Provider Demographics
NPI:1174296446
Name:PAULES, BRIANNA (OTR/L)
Entity Type:Individual
Prefix:
First Name:BRIANNA
Middle Name:
Last Name:PAULES
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 1:25 PEYTON RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-3815
Mailing Address - Country:US
Mailing Address - Phone:717-881-3161
Mailing Address - Fax:
Practice Address - Street 1:1 TRINITY DR E STE 110
Practice Address - Street 2:
Practice Address - City:DILLSBURG
Practice Address - State:PA
Practice Address - Zip Code:17019-8522
Practice Address - Country:US
Practice Address - Phone:717-432-7719
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-31
Last Update Date:2021-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC017861225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist