Individual
BREIA-LYN MACKIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSOTR/L
Contact information
Practice address
641 WOODSON DR, CLAYTON, NC 27527-5547
(518) 729-7755
Mailing address
641 WOODSON DR, CLAYTON, NC 27527-5547
(518) 729-7755
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
014647
NY
225X00000X
Occupational Therapist
Primary
9267
NC
Other
Enumeration date
09/08/2008
Last updated
10/07/2014
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