Provider Demographics
NPI:1306080783
Name:ANDERSON, BARBRA ELLEN (OTR/L)
Entity type:Individual
Prefix:MS
First Name:BARBRA
Middle Name:ELLEN
Last Name:ANDERSON
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 1:76670 ROAD 416
Mailing Address - Street 2:
Mailing Address - City:GOTHENBURG
Mailing Address - State:NE
Mailing Address - Zip Code:69138-3419
Mailing Address - Country:US
Mailing Address - Phone:479-422-2293
Mailing Address - Fax:
Practice Address - Street 1:607 SMITH AVE
Practice Address - Street 2:
Practice Address - City:ELWOOD
Practice Address - State:NE
Practice Address - Zip Code:68937-5236
Practice Address - Country:US
Practice Address - Phone:308-785-3302
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-29
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAR OTR706225X00000X
ARAR OT706225XP0200X
NE1399225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics