Provider Demographics
NPI:1235562265
Name:HAINES, BRITTANY BURTON (COTA/L)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:BURTON
Last Name:HAINES
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2152 MALLARD POINTE DR
Mailing Address - Street 2:
Mailing Address - City:KANNAPOLIS
Mailing Address - State:NC
Mailing Address - Zip Code:28083-6204
Mailing Address - Country:US
Mailing Address - Phone:704-675-3120
Mailing Address - Fax:
Practice Address - Street 1:9597 INDIAN BEECH AVE NW
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28027-3573
Practice Address - Country:US
Practice Address - Phone:973-896-4332
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-13
Last Update Date:2015-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8405224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant