Provider Demographics
NPI:1023340270
Name:BRYANT, KATHRYN ELIZABETH (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:ELIZABETH
Last Name:BRYANT
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:ELIZABETH
Other - Last Name:PURDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:1361 CYPRESS PL
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-2707
Mailing Address - Country:US
Mailing Address - Phone:910-922-0291
Mailing Address - Fax:
Practice Address - Street 1:1361 CYPRESS PL
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-2707
Practice Address - Country:US
Practice Address - Phone:910-922-0291
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-12
Last Update Date:2010-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119004645225X00000X
PAOC011050225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist