Provider Demographics
NPI:1962703116
Name:BARNES, CAROLINE (OT)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:
Last Name:BARNES
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17809 STATE ROUTE 31
Mailing Address - Street 2:MILL VALLEY PLAZA #9
Mailing Address - City:MARYSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43040-9609
Mailing Address - Country:US
Mailing Address - Phone:937-738-7818
Mailing Address - Fax:
Practice Address - Street 1:17809 STATE ROUTE 31
Practice Address - Street 2:MILL VALLEY PLAZA #9
Practice Address - City:MARYSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43040-9609
Practice Address - Country:US
Practice Address - Phone:937-738-7818
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-04
Last Update Date:2010-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2566225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist