Provider Demographics
NPI:1841583143
Name:BRYANT, COURTNEY JAY (MS, OTR/L)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:JAY
Last Name:BRYANT
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2406 APPLEWOOD CT
Mailing Address - Street 2:
Mailing Address - City:PERKASIE
Mailing Address - State:PA
Mailing Address - Zip Code:18944-5442
Mailing Address - Country:US
Mailing Address - Phone:732-763-9304
Mailing Address - Fax:
Practice Address - Street 1:3250 STATE RD
Practice Address - Street 2:
Practice Address - City:SELLERSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18960-1624
Practice Address - Country:US
Practice Address - Phone:215-257-2751
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-18
Last Update Date:2012-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC010974225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist