Provider Demographics
NPI:1194843375
Name:WORSLEY, BRANDY (PTA)
Entity Type:Individual
Prefix:
First Name:BRANDY
Middle Name:
Last Name:WORSLEY
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:BRANDY
Other - Middle Name:
Other - Last Name:BENDIGO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:5751 CHESTERFIELD CT
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45014-3998
Mailing Address - Country:US
Mailing Address - Phone:513-874-9199
Mailing Address - Fax:
Practice Address - Street 1:2222 SPRINGDALE RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45231-1805
Practice Address - Country:US
Practice Address - Phone:513-851-7888
Practice Address - Fax:513-825-1932
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03691225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant