Provider Demographics
NPI:1194477752
Name:HANBERRY, BRITTANY (MHSOT, OTR/L, CBIS)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:HANBERRY
Suffix:
Gender:F
Credentials:MHSOT, OTR/L, CBIS
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:
Other - Last Name:WALKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2733 MISTY ROCK CV
Mailing Address - Street 2:
Mailing Address - City:DACULA
Mailing Address - State:GA
Mailing Address - Zip Code:30019-4827
Mailing Address - Country:US
Mailing Address - Phone:770-833-7580
Mailing Address - Fax:
Practice Address - Street 1:311 COOPER RD
Practice Address - Street 2:
Practice Address - City:LOGANVILLE
Practice Address - State:GA
Practice Address - Zip Code:30052-4976
Practice Address - Country:US
Practice Address - Phone:678-205-5437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-24
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT005786225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist