Provider Demographics
NPI:1912426826
Name:CAMPBELL, BRANDI (COT/L)
Entity Type:Individual
Prefix:
First Name:BRANDI
Middle Name:
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:COT/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7481 FINCH CT
Mailing Address - Street 2:
Mailing Address - City:CARLISLE
Mailing Address - State:OH
Mailing Address - Zip Code:45005-4268
Mailing Address - Country:US
Mailing Address - Phone:937-367-6777
Mailing Address - Fax:
Practice Address - Street 1:7481 FINCH CT
Practice Address - Street 2:
Practice Address - City:CARLISLE
Practice Address - State:OH
Practice Address - Zip Code:45005-4268
Practice Address - Country:US
Practice Address - Phone:937-367-6777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOTA007042224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant