# BRAVE YOGA FOR ALL LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912888702
- **Authorized official:** LISA M IRVINE MS,OTR/L (OCCUPATIONAL THERAPIST)
- **Authorized official phone:** (508) 330-1141

## Contact information

- **Practice address:** 299 CLARK ROAD EXT, FISKDALE, MA 01518-1036
- **Practice address phone:** (508) 330-1141
- **Mailing address:** 299 CLARK ROAD EXT, FISKDALE, MA 01518-1036

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225XP0019X | Physical Rehabilitation Occupational Therapist | — | NULL | Yes |
| 225XP0019X | Physical Rehabilitation Occupational Therapist | — | — | Yes |

## Other

- **Enumeration date:** 09/09/2025
- **Last updated:** 09/09/2025