Provider Demographics
NPI:1396007605
Name:DAVIS, BRITTANY NICOLE (OTR/L)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:NICOLE
Last Name:DAVIS
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 1:2372 EAGLE DR NE
Mailing Address - Street 2:
Mailing Address - City:CONOVER
Mailing Address - State:NC
Mailing Address - Zip Code:28613-9497
Mailing Address - Country:US
Mailing Address - Phone:828-695-6469
Mailing Address - Fax:828-464-5800
Practice Address - Street 1:301 10TH ST NW
Practice Address - Street 2:SUITE F 103
Practice Address - City:CONOVER
Practice Address - State:NC
Practice Address - Zip Code:28613-2419
Practice Address - Country:US
Practice Address - Phone:828-695-6469
Practice Address - Fax:828-464-5800
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-12
Last Update Date:2012-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8039225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist