Individual
BRAXTON WILLOUGHBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
491 FLETCHER PL, BRONX, NY 10457-1407
(718) 215-4330
Mailing address
491 FLETCHER PL, BRONX, NY 10457-1407
(718) 215-4330
Taxonomy
Speciality
Code
Description
License number
State
225XM0800X
Mental Health Occupational Therapist
Primary
026455
NY
Other
Enumeration date
02/23/2024
Last updated
02/23/2024
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