Provider Demographics
NPI:1033249347
Name:BARNETT, MARILYN BETHUNE (LPTA)
Entity Type:Individual
Prefix:MS
First Name:MARILYN
Middle Name:BETHUNE
Last Name:BARNETT
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:831 UNIVERSITY BLVD, EAST
Mailing Address - Street 2:SUITE #14
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20903
Mailing Address - Country:US
Mailing Address - Phone:301-445-3191
Mailing Address - Fax:301-445-3198
Practice Address - Street 1:2185 NORTHLAKE PARKWAY
Practice Address - Street 2:BUILDING 8, SUITE 100
Practice Address - City:TUCKER
Practice Address - State:GA
Practice Address - Zip Code:30084
Practice Address - Country:US
Practice Address - Phone:770-493-6360
Practice Address - Fax:301-445-3198
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2014-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA2363225200000X
VA2306603805225200000X
GAPTA003179225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant