Provider Demographics
NPI:1699136812
Name:BRILEY, LAYIEL (COTA/L)
Entity type:Individual
Prefix:MRS
First Name:LAYIEL
Middle Name:
Last Name:BRILEY
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 RIGGS AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:TN
Mailing Address - Zip Code:37148-1501
Mailing Address - Country:US
Mailing Address - Phone:615-584-6843
Mailing Address - Fax:
Practice Address - Street 1:140 THORNE BLVD
Practice Address - Street 2:
Practice Address - City:GALLATIN
Practice Address - State:TN
Practice Address - Zip Code:37066-1509
Practice Address - Country:US
Practice Address - Phone:615-451-0788
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-15
Last Update Date:2016-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1807224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant