Provider Demographics
NPI:1528387750
Name:EMBRY, BRADY (OTR/L)
Entity Type:Individual
Prefix:
First Name:BRADY
Middle Name:
Last Name:EMBRY
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:BRADY
Other - Middle Name:
Other - Last Name:BOWERMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1008 S SHELBY ST
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40203-3414
Mailing Address - Country:US
Mailing Address - Phone:502-741-9797
Mailing Address - Fax:
Practice Address - Street 1:1008 S SHELBY ST
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40203-3414
Practice Address - Country:US
Practice Address - Phone:502-741-9797
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-27
Last Update Date:2019-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
KY245319225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor