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General NPI Number Information
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NPI Number | 1396979910
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Entity Type | Individual
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Provider Name | BRYTTNEE ROBERTS JOSEPH M.H.S., OTR
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Gender | Female
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Dates
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Enumeration Date | 05/11/2009
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Last Update Date | 05/11/2009
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Provider Practice Location Address
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Address Line | 11701 SAN JOSE BLVD SUITE 210
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City | JACKSONVILLE
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State | FL
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Zip | 32223-0756
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Country | US
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Telephone | 904-858-7450
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Fax |
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Provider Business Mailing Address
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Address Line | 10545 ROUNDWOOD GLEN CT
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City | JACKSONVILLE
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State | FL
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Zip | 32256-9118
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Country | US
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Telephone | 904-374-2528
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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 | OT 10478
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License Number State | FL
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