Provider Demographics
NPI:1447624820
Name:LABELLE, BRIAN (OTR/L)
Entity type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:
Last Name:LABELLE
Suffix:
Gender:M
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 1:11 GARDEN ST
Mailing Address - Street 2:
Mailing Address - City:BARRE
Mailing Address - State:VT
Mailing Address - Zip Code:05641-3916
Mailing Address - Country:US
Mailing Address - Phone:802-238-1316
Mailing Address - Fax:
Practice Address - Street 1:98 HOSPITALITY DR
Practice Address - Street 2:
Practice Address - City:BARRE
Practice Address - State:VT
Practice Address - Zip Code:05641-5360
Practice Address - Country:US
Practice Address - Phone:802-229-0308
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-22
Last Update Date:2015-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT072.0000117225X00000X
FLOT 14589225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist