Provider Demographics
NPI:1376009647
Name:BRODY, BRITTANY NOEL (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:BRITTANY
Middle Name:NOEL
Last Name:BRODY
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 1:8639 TINDLEY RD
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:MD
Mailing Address - Zip Code:21841-2033
Mailing Address - Country:US
Mailing Address - Phone:410-245-3140
Mailing Address - Fax:
Practice Address - Street 1:6270 WORCESTER HWY
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:MD
Practice Address - Zip Code:21841-2224
Practice Address - Country:US
Practice Address - Phone:410-632-5000
Practice Address - Fax:410-632-0364
Is Sole Proprietor?:No
Enumeration Date:2019-02-12
Last Update Date:2019-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD06583225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics