MEDICARE: MS. BRITTANY DEGRAW OTR/L

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	OT20635	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225660137
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. BRITTANY DEGRAW OTR/L

Provider Business Mailing Address
First Line	:	4451 GOLFERS CIR W
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33410-4611
Country	:	US
Telephone Number	:	845-707-2264
Fax Number	:

Provider Business Practice Location Address
First Line	:	8127 MARIPOSA GROVE CIR
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33411-4632
Country	:	US
Telephone Number	:	561-651-9615
Fax Number	:	561-355-0343

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/08/2020
Last Update Date	:	02/08/2020

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