Provider Demographics
NPI:1477963007
Name:BRIMACOMBE, JUDY RAE (OTR/L)
Entity Type:Individual
Prefix:
First Name:JUDY
Middle Name:RAE
Last Name:BRIMACOMBE
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 1:16476 SHELDON RD
Mailing Address - Street 2:
Mailing Address - City:BROOKPARK
Mailing Address - State:OH
Mailing Address - Zip Code:44142-3774
Mailing Address - Country:US
Mailing Address - Phone:216-310-2634
Mailing Address - Fax:
Practice Address - Street 1:4550 W. 150TH STREET
Practice Address - Street 2:RG JONES ELEMENTARY SCHOOL
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44135
Practice Address - Country:US
Practice Address - Phone:216-889-4071
Practice Address - Fax:216-433-7249
Is Sole Proprietor?:No
Enumeration Date:2014-05-05
Last Update Date:2014-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT 000545225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics