Provider Demographics
NPI:1346796190
Name:AGLER, BRIANA LYNN (COTA-L)
Entity Type:Individual
Prefix:
First Name:BRIANA
Middle Name:LYNN
Last Name:AGLER
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 1:375 WEST MAIN ST.
Mailing Address - Street 2:
Mailing Address - City:WEST JEFFERSON
Mailing Address - State:OH
Mailing Address - Zip Code:43162
Mailing Address - Country:US
Mailing Address - Phone:614-879-7661
Mailing Address - Fax:
Practice Address - Street 1:375 WEST MAIN ST.
Practice Address - Street 2:
Practice Address - City:WEST JEFFERSON
Practice Address - State:OH
Practice Address - Zip Code:43162
Practice Address - Country:US
Practice Address - Phone:614-879-7661
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-31
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOTA.06582224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant