Provider Demographics
NPI:1578645495
Name:BRASHER, MARY LENORA (MS, OTR/L)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:LENORA
Last Name:BRASHER
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:LENORA
Other - Last Name:BURKART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1420 BEVERLY RD STE 210
Mailing Address - Street 2:
Mailing Address - City:MC LEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22101-3736
Mailing Address - Country:US
Mailing Address - Phone:703-288-8260
Mailing Address - Fax:
Practice Address - Street 1:1420 BEVERLY RD STE 210
Practice Address - Street 2:
Practice Address - City:MC LEAN
Practice Address - State:VA
Practice Address - Zip Code:22101-3736
Practice Address - Country:US
Practice Address - Phone:703-703-2888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119004279225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist