Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | ||
N | 225X00000X | Occupational Therapist | OT006993 | GA |
N | 225XF0002X | Feeding, Eating & Swallowing | OT006993 | GA |
N | 225XH1200X | Occupational Therapist - Hand | OT006993 | GA |
N | 2251H1300X | Human Factors | OT006993 | GA |
N | 225XH1300X | Human Factors | OT006993 | GA |
N | 225XL0004X | Low Vision | OT006993 | GA |
N | 225XM0800X | Mental Health | OT006993 | GA |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | OT006993 | GA |
N | 225XP0200X | Occupational Therapist - Pediatrics | OT006993 | GA |
NPI | 1184117699 |
---|---|
Provider Name | Ms. Brandi Nicole Deveaux |
First Address | Willingboro, NJ 08046-3919 |
Second Address | Bensalem, PA 19020 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2018 |
Last Update Date | 09/05/2021 |