Provider Demographics
NPI:1730113002
Name:BARNES, PATRICIA ANNE (MA, OT/L)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:ANNE
Last Name:BARNES
Suffix:
Gender:F
Credentials:MA, OT/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1510 MIDVALE AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-4334
Mailing Address - Country:US
Mailing Address - Phone:410-744-0472
Mailing Address - Fax:
Practice Address - Street 1:1510 MIDVALE AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21228-4334
Practice Address - Country:US
Practice Address - Phone:410-744-0472
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD1413225X00000X, 225XN1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Not Answered225XN1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistNeurorehabilitation