Provider Demographics
NPI:1992996920
Name:BARNES, DEBRA LYNN (MA, OTR/L)
Entity type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:LYNN
Last Name:BARNES
Suffix:
Gender:F
Credentials:MA, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:326 CARRERA DR
Mailing Address - Street 2:
Mailing Address - City:MILL VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94941-3997
Mailing Address - Country:US
Mailing Address - Phone:415-847-6273
Mailing Address - Fax:
Practice Address - Street 1:326 CARRERA DR
Practice Address - Street 2:
Practice Address - City:MILL VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94941-3997
Practice Address - Country:US
Practice Address - Phone:415-847-6273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-06
Last Update Date:2007-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA4440225X00000X
CAOT 4440225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist