Provider Demographics
NPI:1396979910
Name:JOSEPH, BRYTTNEE ROBERTS (MHS, OTR)
Entity type:Individual
Prefix:
First Name:BRYTTNEE
Middle Name:ROBERTS
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:MHS, OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10545 ROUNDWOOD GLEN CT
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-9118
Mailing Address - Country:US
Mailing Address - Phone:904-374-2528
Mailing Address - Fax:
Practice Address - Street 1:11701 SAN JOSE BLVD
Practice Address - Street 2:SUITE 210
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32223-0756
Practice Address - Country:US
Practice Address - Phone:904-858-7450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-11
Last Update Date:2009-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT 10478225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist