Provider Demographics
NPI:1992974257
Name:BARTHMAN, ALIDA JEAN
Entity type:Individual
Prefix:
First Name:ALIDA
Middle Name:JEAN
Last Name:BARTHMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:840 HIGHVIEW DR APT B
Mailing Address - Street 2:
Mailing Address - City:NEW RICHMOND
Mailing Address - State:WI
Mailing Address - Zip Code:54017-2289
Mailing Address - Country:US
Mailing Address - Phone:715-554-3527
Mailing Address - Fax:
Practice Address - Street 1:840 HIGHVIEW DR APT B
Practice Address - Street 2:
Practice Address - City:NEW RICHMOND
Practice Address - State:WI
Practice Address - Zip Code:54017-2289
Practice Address - Country:US
Practice Address - Phone:715-554-3527
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-20
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1788027224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant