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General NPI Number Information
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NPI Number | 1043783681
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Entity Type | Individual
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Provider Name | BRITTANY E HAYNIE
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Gender | Female
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Dates
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Enumeration Date | 01/07/2019
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Last Update Date | 08/04/2024
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Provider Practice Location Address
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Address Line | 2625 BARNA AVE STE H
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City | TITUSVILLE
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State | FL
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Zip | 32780-3417
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Country | US
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Telephone | 321-362-4099
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Fax |
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Provider Business Mailing Address
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Address Line | 814 BARBADOS AVE
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City | MELBOURNE
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State | FL
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Zip | 32901-8630
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Country | US
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Telephone | 724-987-3802
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OC015943
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT20947
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License Number State | FL
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