Provider Demographics
NPI:1285239780
Name:SUMNEY, BRAYDEN RICHARD (OTR)
Entity type:Individual
Prefix:
First Name:BRAYDEN
Middle Name:RICHARD
Last Name:SUMNEY
Suffix:
Gender:M
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5466 PARKER LANDINGS DR UNIT 202
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-8351
Mailing Address - Country:US
Mailing Address - Phone:330-309-4306
Mailing Address - Fax:
Practice Address - Street 1:841 W MARION RD
Practice Address - Street 2:
Practice Address - City:MOUNT GILEAD
Practice Address - State:OH
Practice Address - Zip Code:43338-1031
Practice Address - Country:US
Practice Address - Phone:419-947-2015
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-02
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT011002225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist