Provider Demographics
NPI:1396182192
Name:RICHARDS, BRENDA (OTR/L)
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:
Last Name:RICHARDS
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 1:6325 COCHRAN RD STE 2
Mailing Address - Street 2:
Mailing Address - City:SOLON
Mailing Address - State:OH
Mailing Address - Zip Code:44139-3930
Mailing Address - Country:US
Mailing Address - Phone:440-498-1100
Mailing Address - Fax:440-498-1149
Practice Address - Street 1:6325 COCHRAN RD STE 2
Practice Address - Street 2:
Practice Address - City:SOLON
Practice Address - State:OH
Practice Address - Zip Code:44139-3930
Practice Address - Country:US
Practice Address - Phone:440-498-1100
Practice Address - Fax:440-498-1149
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-03
Last Update Date:2020-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3647225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist