Provider Demographics
NPI:1639746522
Name:KEHOE, BRIANNE (MOT, ORT/L)
Entity Type:Individual
Prefix:
First Name:BRIANNE
Middle Name:
Last Name:KEHOE
Suffix:
Gender:F
Credentials:MOT, ORT/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 412307
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-2307
Mailing Address - Country:US
Mailing Address - Phone:914-294-4050
Mailing Address - Fax:613-760-8306
Practice Address - Street 1:3509 FESTIVAL PARK PLZ
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:VA
Practice Address - Zip Code:23831-4449
Practice Address - Country:US
Practice Address - Phone:804-946-1250
Practice Address - Fax:804-510-2252
Is Sole Proprietor?:No
Enumeration Date:2021-06-08
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119009023225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist