Provider Demographics
NPI:1902591746
Name:BRITTON, ELLEN MARIE (OTR/L)
Entity type:Individual
Prefix:
First Name:ELLEN
Middle Name:MARIE
Last Name:BRITTON
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1194 HATCHER CT
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41051-6950
Mailing Address - Country:US
Mailing Address - Phone:812-584-8470
Mailing Address - Fax:
Practice Address - Street 1:3012 RIGGS RD
Practice Address - Street 2:
Practice Address - City:ERLANGER
Practice Address - State:KY
Practice Address - Zip Code:41018-3031
Practice Address - Country:US
Practice Address - Phone:859-283-8600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-07
Last Update Date:2023-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY284428225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist