Provider Demographics
NPI:1528277712
Name:GAUNT, BARBARA DIANE (OTR)
Entity type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:DIANE
Last Name:GAUNT
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:790 REMINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-4909
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1004 N WALNUT ST
Practice Address - Street 2:SUITE 102
Practice Address - City:MILFORD
Practice Address - State:DE
Practice Address - Zip Code:19963-1244
Practice Address - Country:US
Practice Address - Phone:302-422-6670
Practice Address - Fax:302-422-6550
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEU1-0000819225XH1200X
225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
1528277712OtherCHAMPUS TRICARE
3535011000OtherIBC AMERIHEALTH
11750416OtherCAQH
DEP01084205OtherMEDICARE RAILROAD
DE1528277712Medicaid
DE1528277712Medicaid