Provider Demographics
NPI:1508940735
Name:HAYWARD, BRANDI RAE (MS OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:BRANDI
Middle Name:RAE
Last Name:HAYWARD
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 1:112 STURBRIDGE CT
Mailing Address - Street 2:
Mailing Address - City:WYOMISSING
Mailing Address - State:PA
Mailing Address - Zip Code:19610-2662
Mailing Address - Country:US
Mailing Address - Phone:610-781-4616
Mailing Address - Fax:
Practice Address - Street 1:112 STURBRIDGE CT
Practice Address - Street 2:
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-2662
Practice Address - Country:US
Practice Address - Phone:610-781-4616
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2014-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC009583225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist