Healthcare Provider Details

I. General information

NPI: 1942689583
Provider Name (Legal Business Name): BRITTNEY TARA WALDEN MS, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/28/2015
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

343 INVERNESS ST
ZEBULON NC
27597-3310
US

IV. Provider business mailing address

343 INVERNESS ST
ZEBULON NC
27597-3310
US

V. Phone/Fax

Practice location:
  • Phone: 919-480-7008
  • Fax: 919-882-8502
Mailing address:
  • Phone: 732-770-5706
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number9480
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: