MEDICARE: EMILY BRETZ OTD, 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	225XP0200X	Pediatric Occupational Therapist	OC019481	PA

General Provider Information

NPI Number	:	1902677446
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY BRETZ OTD, OTR/L

Provider Business Mailing Address
First Line	:	1108 TALLEYRAND RD
Second Line	:
City	:	WEST CHESTER
State	:	PA
Zip	:	19382-7417
Country	:	US
Telephone Number	:	610-425-0246
Fax Number	:

Provider Business Practice Location Address
First Line	:	1108 TALLEYRAND RD
Second Line	:
City	:	WEST CHESTER
State	:	PA
Zip	:	19382-7417
Country	:	US
Telephone Number	:	610-425-0246
Fax Number	:

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

Provider Enumeration Date	:	01/12/2024
Last Update Date	:	01/12/2024

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