Basic Information
| Provider Information | |||||||||
| NPI: | 1194137224 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AKBARI | ||||||||
| FirstName: | BRANDY | ||||||||
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| Credential: | COTA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3727 QUEEN ANNE LOOP APT 304 | ||||||||
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| City: | FAYETTEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 283067899 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7063317828 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1700 PAMALEE DR | ||||||||
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| City: | FAYETTEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 283012824 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9104882295 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/23/2014 | ||||||||
| LastUpdateDate: | 05/23/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 224Z00000X | 9184 | NC | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant |
No ID Information.