Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 07713 | MD |
N | 225XG0600X | Occupational Therapist - Gerontology | 07713 | MD |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | 07713 | MD |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 07713 | MD |
NPI | 1992289359 |
---|---|
Provider Name | Mrs. Kaitlin Nicole Barry |
First Address | Pasadena, MD 21122-4169 |
Second Address | Annapolis, MD 21401-3746 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/09/2018 |
Last Update Date | 21/09/2018 |