Provider Demographics
| NPI: | 1184117699 |
|---|---|
| Name: | DEVEAUX, BRANDI NICOLE (OTR/L, CLT) |
| Entity type: | Individual |
| Prefix: | MS |
| First Name: | BRANDI |
| Middle Name: | NICOLE |
| Last Name: | DEVEAUX |
| Suffix: | |
| Gender: | F |
| Credentials: | OTR/L, CLT |
| Other - Prefix: | |
| Other - First Name: | |
| Other - Middle Name: | |
| Other - Last Name: | |
| Other - Suffix: | |
| Other - Last Name Type: | |
| Other - Credentials: | |
| Mailing Address - Street 1: | 1111 COOPERSKILL RD |
| Mailing Address - Street 2: | |
| Mailing Address - City: | CHERRY HILL |
| Mailing Address - State: | NJ |
| Mailing Address - Zip Code: | 08034-2836 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 609-346-0504 |
| Mailing Address - Fax: | 360-294-2955 |
| Practice Address - Street 1: | 3331 STREET ROAD |
| Practice Address - Street 2: | TWO GREENWOOD SQUARE/STE 107 |
| Practice Address - City: | BENSALEM |
| Practice Address - State: | PA |
| Practice Address - Zip Code: | 19020 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 912-452-0233 |
| Practice Address - Fax: | 360-294-2955 |
| Is Sole Proprietor?: | Yes |
| Enumeration Date: | 2018-06-08 |
| Last Update Date: | 2022-06-23 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Licenses
| State | License ID | Taxonomies |
|---|---|---|
| GA | OT006993 | 225X00000X, 225XF0002X, 225XH1200X, 225XH1300X, 225XL0004X, 225XM0800X, 225XP0019X, 225XP0200X |
| 225XG0600X, 225X00000X |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization |
|---|---|---|---|---|
| Yes | 225X00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | |
| No | 225XF0002X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Feeding, Eating & Swallowing |
| No | 225XG0600X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Gerontology |
| No | 225XH1200X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Hand |
| No | 225XH1300X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Human Factors |
| No | 225XL0004X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Low Vision |
| No | 225XM0800X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Mental Health |
| No | 225XP0019X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Physical Rehabilitation |
| No | 225XP0200X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Pediatrics |
