Brittney Butler

Individual provider Active NPI Occupational Therapy Assistant · St Simons Island, GA

NPI 1194276337 · NPPES record last updated Oct 24, 2016

Key facts

NPI
1194276337
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
OTA001768 (GA)
Practice address
111 Renegar Way
St Simons Island, GA 31522
Phone
(912) 634-4781
NPI assigned
Oct 24, 2016
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
OTA001768GAMDOccupational Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X OTA001768 GA Yes

Addresses

Primary practice location

111 Renegar Way
St Simons Island, GA 31522

Mailing address

511 Nottingham Dr
Brunswick, GA 31525
Phone (912) 571-4516

Other providers in St Simons Island, GA

All providers in St Simons Island, GA · Occupational Therapy Assistant in Georgia

Sources for this page

Verify at the official NPI Registry.