Individual
MRS. BRANDY LYNN LOCKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
136 DONAHUE MANOR RD, BEDFORD, PA 15522-9728
(814) 623-9075
Mailing address
5168 FOREST AVE, BEDFORD, PA 15522-6642
(814) 623-9075
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OP005914
PA
Other
Enumeration date
10/01/2008
Last updated
10/01/2008
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