Provider Demographics
NPI:1598047151
Name:MORRIS, BRIANNE (OTR)
Entity Type:Individual
Prefix:
First Name:BRIANNE
Middle Name:
Last Name:MORRIS
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 CRESCENT PL
Mailing Address - Street 2:
Mailing Address - City:HO HO KUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07423-1403
Mailing Address - Country:US
Mailing Address - Phone:201-669-9807
Mailing Address - Fax:
Practice Address - Street 1:3196 KENNEDY BLVD
Practice Address - Street 2:3RD FLOOR
Practice Address - City:UNION CITY
Practice Address - State:NJ
Practice Address - Zip Code:07087-2436
Practice Address - Country:US
Practice Address - Phone:201-223-4949
Practice Address - Fax:201-223-9722
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-09
Last Update Date:2011-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00497600225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist