Provider Demographics
NPI:1245393420
Name:HUDDLESTON, BARBARA (OT)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:HUDDLESTON
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3909 NATIONAL DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BURTONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20866-1191
Mailing Address - Country:US
Mailing Address - Phone:301-421-1125
Mailing Address - Fax:301-500-2175
Practice Address - Street 1:3909 NATIONAL DR
Practice Address - Street 2:SUITE 100
Practice Address - City:BURTONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20866-1191
Practice Address - Country:US
Practice Address - Phone:301-421-1125
Practice Address - Fax:301-500-2175
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2014-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCOT010000354225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand