Provider Demographics
NPI:1699328542
Name:BOSLEY, BRITTANY LYNNE (OTR/L)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:LYNNE
Last Name:BOSLEY
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:
Other - Last Name:DALIEGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:1377 MOTOR PKWY STE 307
Mailing Address - Street 2:
Mailing Address - City:ISLANDIA
Mailing Address - State:NY
Mailing Address - Zip Code:11749-5258
Mailing Address - Country:US
Mailing Address - Phone:631-580-5200
Mailing Address - Fax:631-580-5222
Practice Address - Street 1:73 JEFFERSON CT
Practice Address - Street 2:
Practice Address - City:ZION CROSSROADS
Practice Address - State:VA
Practice Address - Zip Code:22942
Practice Address - Country:US
Practice Address - Phone:540-832-9012
Practice Address - Fax:540-832-9013
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-19
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY170806225X00000X
VA0119008298225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty