Provider Demographics
NPI:1316697907
Name:HULLINGER, BRIANA M (COTA/L)
Entity type:Individual
Prefix:MRS
First Name:BRIANA
Middle Name:M
Last Name:HULLINGER
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:MISS
Other - First Name:BRIANA
Other - Middle Name:M
Other - Last Name:MCCLELLAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1120 LA BREA AVE
Mailing Address - Street 2:
Mailing Address - City:TITUSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32780-5427
Mailing Address - Country:US
Mailing Address - Phone:321-960-7388
Mailing Address - Fax:
Practice Address - Street 1:1120 LA BREA AVE
Practice Address - Street 2:
Practice Address - City:TITUSVILLE
Practice Address - State:FL
Practice Address - Zip Code:32780-5427
Practice Address - Country:US
Practice Address - Phone:321-960-7388
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-25
Last Update Date:2022-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOTA16918224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant