Provider Demographics
NPI:1407357155
Name:BARBER, MARY WHITEHOUSE (OTRL)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:WHITEHOUSE
Last Name:BARBER
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2098 S MAIN ST RM 1135
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-5827
Mailing Address - Country:US
Mailing Address - Phone:734-232-7077
Mailing Address - Fax:734-998-4733
Practice Address - Street 1:2098 S MAIN ST RM 1135
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-5827
Practice Address - Country:US
Practice Address - Phone:734-232-7077
Practice Address - Fax:734-998-4733
Is Sole Proprietor?:No
Enumeration Date:2018-02-27
Last Update Date:2018-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201002587225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand