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General NPI Number Information
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NPI Number | 1225358781
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Entity Type | Individual
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Provider Name | MADELYN ORTIZ BRITO MA, OT/L
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Gender | Female
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Dates
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Enumeration Date | 06/08/2010
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Last Update Date | 04/05/2019
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Provider Practice Location Address
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Address Line | 2710 IKE ST TRLR 22
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City | CHESAPEAKE
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State | VA
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Zip | 23324
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Country | US
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Telephone | 787-635-0364
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Fax |
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Provider Business Mailing Address
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Address Line | 2710 IKE ST TRLR 22
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City | CHESAPEAKE
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State | VA
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Zip | 23324-2913
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Country | US
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Telephone | 787-635-0364
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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 | 103TC1900X
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Taxonomy Name | Counseling
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License Number | 4024
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License Number State | PR
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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 | 1006
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License Number State | PR
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