Individual
BRADY LYN AVINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
214 S MUNSON RD, SWANTON, OH 43558-1210
(419) 825-1145
Mailing address
PO BOX 53249, PETTISVILLE, OH 43553-0249
(419) 822-7764
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT010234
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OT010234
NATIONAL BOARD OF OCCUPATIONAL THERAPY
OH
Enumeration date
08/14/2018
Last updated
08/14/2018
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