Provider Demographics
NPI:1356469571
Name:MILES BRESLIN, DINA MARIE (OTR)
Entity Type:Individual
Prefix:
First Name:DINA
Middle Name:MARIE
Last Name:MILES BRESLIN
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 EARLY PRIDE CT
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:MD
Mailing Address - Zip Code:21122-3845
Mailing Address - Country:US
Mailing Address - Phone:410-437-5367
Mailing Address - Fax:
Practice Address - Street 1:320 EARLY PRIDE CT
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:MD
Practice Address - Zip Code:21122-3845
Practice Address - Country:US
Practice Address - Phone:410-437-5367
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD02475225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics