Individual
MRS. BRENDA LEE MAHON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTD/OTR
Contact information
Practice address
350 CLYDE MORRIS BLVD, ORMOND BEACH, FL 32174-5993
(386) 868-0505
Mailing address
563 SEVILLE PKWY, SAINT AUGUSTINE, FL 32086-9037
(570) 228-5111
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
—
—
225XG0600X
Gerontology Occupational Therapist
0193350
NY
225XG0600X
Gerontology Occupational Therapist
Primary
46TR00529000
NJ
225XG0600X
Gerontology Occupational Therapist
OC011466
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
46TR00529000
PROFESSIONAL LICENSE
NJ
Enumeration date
07/26/2007
Last updated
03/10/2025
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