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General NPI Number Information
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NPI Number | 1083440911
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Entity Type | Individual
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Provider Name | BRIELLE ODD DROT, OTR/L
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Gender | Female
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Dates
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Enumeration Date | 09/09/2024
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Last Update Date | 09/09/2024
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Provider Practice Location Address
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Address Line | 1124 PATRIOT WAY
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City | EASTAMPTON
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State | NJ
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Zip | 08060-9624
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Country | US
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Telephone | 856-492-1355
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Fax |
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Provider Business Mailing Address
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Address Line | 204 ARK RD STE 103C
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City | MOUNT LAUREL
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State | NJ
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Zip | 08054-3100
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Country | US
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Telephone |
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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 | 46TR01195100
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License Number State | NJ
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