Provider Demographics
NPI:1538574553
Name:MARSHALL, BRITTANY FOX (OTR/L)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:FOX
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:LEIGH
Other - Last Name:FOX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:944 CHERRY ST E
Mailing Address - Street 2:
Mailing Address - City:CANAL FULTON
Mailing Address - State:OH
Mailing Address - Zip Code:44614-8669
Mailing Address - Country:US
Mailing Address - Phone:330-854-4281
Mailing Address - Fax:330-854-0829
Practice Address - Street 1:7452 FULTON DR NW STE A
Practice Address - Street 2:
Practice Address - City:MASSILLON
Practice Address - State:OH
Practice Address - Zip Code:44646-9393
Practice Address - Country:US
Practice Address - Phone:254-774-9991
Practice Address - Fax:254-744-9980
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-27
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT009018225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0259022Medicaid