Provider Demographics
NPI:1447827134
Name:BRANTON, CHARLOTTE (OTR/L)
Entity type:Individual
Prefix:
First Name:CHARLOTTE
Middle Name:
Last Name:BRANTON
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 1:918 WINDY RD
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27502-2410
Mailing Address - Country:US
Mailing Address - Phone:216-772-1030
Mailing Address - Fax:
Practice Address - Street 1:1503 MICHAELS RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23229-4822
Practice Address - Country:US
Practice Address - Phone:804-288-6245
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-10
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119-008998225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist