Individual
TAMMY ANN BRALLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
245 NORTH ST, BRISTOL, VA 24201-3274
(276) 669-4711
Mailing address
18394 REPASS ST, ABINGDON, VA 24210-8054
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0131000010
VA
224Z00000X
Occupational Therapy Assistant
OTA0000001918
TN
Other
Enumeration date
10/23/2016
Last updated
10/23/2016
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