Provider Demographics
NPI:1225700552
Name:BARIBEAU, BARBARA ANN (PT)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:ANN
Last Name:BARIBEAU
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 WINDORF CIR
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:ME
Mailing Address - Zip Code:04011-2917
Mailing Address - Country:US
Mailing Address - Phone:207-844-8280
Mailing Address - Fax:207-844-8274
Practice Address - Street 1:12 WINDORF CIR
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:ME
Practice Address - Zip Code:04011-2917
Practice Address - Country:US
Practice Address - Phone:207-844-8280
Practice Address - Fax:207-844-8274
Is Sole Proprietor?:No
Enumeration Date:2021-10-05
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPT667225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist