Provider Demographics
NPI:1275170235
Name:BRALEY, AMY (OTR/L)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:BRALEY
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 1:2564 TRADEWINDS DR
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95747-7142
Mailing Address - Country:US
Mailing Address - Phone:916-690-0739
Mailing Address - Fax:
Practice Address - Street 1:LOVE JOY ADHC
Practice Address - Street 2:10293 ROCKINGHAM DR
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95827
Practice Address - Country:US
Practice Address - Phone:916-661-6194
Practice Address - Fax:916-431-7281
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-09
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15226225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist