Provider Demographics
NPI:1528427093
Name:MCCABE, BRITTANY JOY (OT)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:JOY
Last Name:MCCABE
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15160 FOLIAGE AVE STE 170
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55124-5916
Mailing Address - Country:US
Mailing Address - Phone:952-683-1745
Mailing Address - Fax:952-683-1746
Practice Address - Street 1:15160 FOLIAGE AVE STE 170
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55124-5916
Practice Address - Country:US
Practice Address - Phone:952-683-1745
Practice Address - Fax:952-683-1746
Is Sole Proprietor?:No
Enumeration Date:2016-02-12
Last Update Date:2020-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT17590225X00000X
NE2105225X00000X
MN105793225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47065477702Medicaid