Basic Information
| Provider Information | |||||||||
| NPI: | 1083732259 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TOBIN | ||||||||
| FirstName: | BRANDI | ||||||||
| MiddleName: | DIANE | ||||||||
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| Credential: | OTR | ||||||||
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| Mailing Information | |||||||||
| Address1: | 902 SOM CENTER RD APT 104 | ||||||||
| Address2: | |||||||||
| City: | CLEVELAND | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441433569 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4406653238 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3 MERIT DR. | ||||||||
| Address2: | |||||||||
| City: | RICHMOND HEIGHTS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441431456 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2162619600 | ||||||||
| FaxNumber: | 2162619662 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/27/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | OT5925 | OH | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.