Provider Demographics
NPI:1083725477
Name:BARTH, VICKI L (OTR L)
Entity Type:Individual
Prefix:
First Name:VICKI
Middle Name:L
Last Name:BARTH
Suffix:
Gender:F
Credentials:OTR L
Other - Prefix:
Other - First Name:VICKI
Other - Middle Name:L
Other - Last Name:RUMSEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3915 GOLDEN VALLEY ROAD
Mailing Address - Street 2:COURAGE CENTER
Mailing Address - City:GOLDEN VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55422-4298
Mailing Address - Country:US
Mailing Address - Phone:763-520-0435
Mailing Address - Fax:763-520-0355
Practice Address - Street 1:1710 SUBURBAN AVE
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55106-6636
Practice Address - Country:US
Practice Address - Phone:651-254-3200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN101188225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN6407007OtherMEDICA
MN49Q08BAOtherBCBS MINNESOTA
MNHP43647OtherHEALTHPARTNERS