Provider Demographics
NPI:1457861494
Name:RESH, BRYANNA ROCHELLE (OTR/L)
Entity Type:Individual
Prefix:MISS
First Name:BRYANNA
Middle Name:ROCHELLE
Last Name:RESH
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 1:1128 MOONBOW DR
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21157-3947
Mailing Address - Country:US
Mailing Address - Phone:443-974-0808
Mailing Address - Fax:
Practice Address - Street 1:3583 SCOTLAND RD
Practice Address - Street 2:
Practice Address - City:SCOTLAND
Practice Address - State:PA
Practice Address - Zip Code:17254-1200
Practice Address - Country:US
Practice Address - Phone:717-709-7997
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-04
Last Update Date:2017-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC015222225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics