Provider Demographics
NPI:1891125365
Name:BRYANT, VALERIE (OTR)
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:
Last Name:BRYANT
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:VALERIE
Other - Middle Name:
Other - Last Name:TATA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:818 BRANT DR
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:DE
Mailing Address - Zip Code:19720-8905
Mailing Address - Country:US
Mailing Address - Phone:302-743-4701
Mailing Address - Fax:302-328-6262
Practice Address - Street 1:818 BRANT DR
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:DE
Practice Address - Zip Code:19720-8905
Practice Address - Country:US
Practice Address - Phone:302-743-4701
Practice Address - Fax:302-328-6262
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-20
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEU10001338225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist