Provider Demographics
NPI:1851908222
Name:HALL, BRITTANY (LMT,COTA)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:HALL
Suffix:
Gender:F
Credentials:LMT,COTA
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:
Other - Last Name:BUCKLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3151 SOARING GULLS DR UNIT 2087
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-7039
Mailing Address - Country:US
Mailing Address - Phone:702-964-9648
Mailing Address - Fax:
Practice Address - Street 1:3151 SOARING GULLS DR UNIT 2087
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-7039
Practice Address - Country:US
Practice Address - Phone:702-964-9648
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-29
Last Update Date:2020-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist