Provider Demographics
NPI:1437474111
Name:BRASWELL, REGINA ANNE LILLY (OTR/L)
Entity type:Individual
Prefix:
First Name:REGINA
Middle Name:ANNE LILLY
Last Name:BRASWELL
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 1:11546 NORTHCROSS LN
Mailing Address - Street 2:
Mailing Address - City:SAN ANGELO
Mailing Address - State:TX
Mailing Address - Zip Code:76904-3628
Mailing Address - Country:US
Mailing Address - Phone:501-732-6224
Mailing Address - Fax:
Practice Address - Street 1:908 1ST ST
Practice Address - Street 2:
Practice Address - City:OZONA
Practice Address - State:TX
Practice Address - Zip Code:76943
Practice Address - Country:US
Practice Address - Phone:253-929-8723
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-06
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROTR2346225XP0200X
TX118742225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics