Provider Demographics
NPI:1598170136
Name:LABRIE, MICHAL (OTR/L)
Entity Type:Individual
Prefix:
First Name:MICHAL
Middle Name:
Last Name:LABRIE
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 1:515 BRICK BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08723-6009
Mailing Address - Country:US
Mailing Address - Phone:732-840-8100
Mailing Address - Fax:732-840-0559
Practice Address - Street 1:515 BRICK BLVD STE B
Practice Address - Street 2:
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08723-6009
Practice Address - Country:US
Practice Address - Phone:732-840-8100
Practice Address - Fax:732-840-0559
Is Sole Proprietor?:No
Enumeration Date:2014-06-23
Last Update Date:2021-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018924225X00000X
NJ46TR00962300225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist