Provider Demographics
NPI:1275796427
Name:HALL, BRIAN FREEMAN (COTA/L)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:FREEMAN
Last Name:HALL
Suffix:
Gender:M
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 1:102 TATTERSALL DR
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08016-4323
Mailing Address - Country:US
Mailing Address - Phone:609-747-1444
Mailing Address - Fax:
Practice Address - Street 1:102 TATTERSALL DR
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08016-4323
Practice Address - Country:US
Practice Address - Phone:609-747-1444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-08
Last Update Date:2008-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant