Provider Demographics
NPI:1750911616
Name:YORK, BREANNE (OTR/L)
Entity type:Individual
Prefix:
First Name:BREANNE
Middle Name:
Last Name:YORK
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 GILBERT DR APT 109
Mailing Address - Street 2:
Mailing Address - City:MERRIMACK
Mailing Address - State:NH
Mailing Address - Zip Code:03054-2984
Mailing Address - Country:US
Mailing Address - Phone:207-768-8045
Mailing Address - Fax:
Practice Address - Street 1:1 HAMPTON RD UNIT 200
Practice Address - Street 2:
Practice Address - City:EXETER
Practice Address - State:NH
Practice Address - Zip Code:03833-2995
Practice Address - Country:US
Practice Address - Phone:603-775-7575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-20
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225X00000X
NH3190225X00000X
CO0006175225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist