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Individual

BRAELYN HATHAWAY BEAL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTD

Contact information

Practice address
3905 UNIVERSITY DR, DURHAM, NC 27707-2517
(919) 928-0204
Mailing address
4225 LARCHMONT RD APT 236, DURHAM, NC 27707-5972
(864) 569-5695

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
225XP0200X
Pediatric Occupational Therapist
Primary
16986
NC

Other

Enumeration date
11/11/2020
Last updated
07/17/2024
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