Provider Demographics
NPI:1821840448
Name:RUDD, BRITTANY (OT)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:RUDD
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 PARK VIEW DR
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:NC
Mailing Address - Zip Code:28012-3092
Mailing Address - Country:US
Mailing Address - Phone:248-275-8853
Mailing Address - Fax:
Practice Address - Street 1:328 WHIPPOORWILL LN
Practice Address - Street 2:
Practice Address - City:MOUNT HOLLY
Practice Address - State:NC
Practice Address - Zip Code:28120-9765
Practice Address - Country:US
Practice Address - Phone:704-827-3788
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-05
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12265225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist