Provider Demographics
NPI:1194137224
Name:AKBARI, BRANDY (COTA)
Entity type:Individual
Prefix:
First Name:BRANDY
Middle Name:
Last Name:AKBARI
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3727 QUEEN ANNE LOOP APT 304
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28306-7899
Mailing Address - Country:US
Mailing Address - Phone:706-331-7828
Mailing Address - Fax:
Practice Address - Street 1:1700 PAMALEE DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28301-2824
Practice Address - Country:US
Practice Address - Phone:910-488-2295
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-23
Last Update Date:2014-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9184224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant