Provider Demographics
NPI:1275864951
Name:BARRIENTOS, DOUGLAS K (OTR-L)
Entity Type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:K
Last Name:BARRIENTOS
Suffix:
Gender:M
Credentials:OTR-L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6504 S 108TH AVE
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68137-4713
Mailing Address - Country:US
Mailing Address - Phone:402-871-9349
Mailing Address - Fax:
Practice Address - Street 1:655 CRAIG RD STE 150
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-7173
Practice Address - Country:US
Practice Address - Phone:888-262-6966
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-20
Last Update Date:2010-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1225225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist