Provider Demographics
NPI:1295518496
Name:CASH, BRYANT SKYLER (COTA/L)
Entity type:Individual
Prefix:
First Name:BRYANT
Middle Name:SKYLER
Last Name:CASH
Suffix:
Gender:M
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5113 CANTERBURY RD
Mailing Address - Street 2:
Mailing Address - City:SHELBY
Mailing Address - State:NC
Mailing Address - Zip Code:28152-8705
Mailing Address - Country:US
Mailing Address - Phone:704-472-4538
Mailing Address - Fax:
Practice Address - Street 1:518 OLD US 221 HWY
Practice Address - Street 2:
Practice Address - City:RUTHERFORDTON
Practice Address - State:NC
Practice Address - Zip Code:28139-8670
Practice Address - Country:US
Practice Address - Phone:828-287-7655
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-14
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC16155224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant