Provider Demographics
NPI:1568887446
Name:EVANS, BARBARA ANNETTE (OTR/L)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:ANNETTE
Last Name:EVANS
Suffix:
Gender:F
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 1:1709 JAMES RIVER RD
Mailing Address - Street 2:
Mailing Address - City:OZARK
Mailing Address - State:MO
Mailing Address - Zip Code:65721-6724
Mailing Address - Country:US
Mailing Address - Phone:417-581-1234
Mailing Address - Fax:888-550-3518
Practice Address - Street 1:1709 JAMES RIVER RD
Practice Address - Street 2:
Practice Address - City:OZARK
Practice Address - State:MO
Practice Address - Zip Code:65721-6724
Practice Address - Country:US
Practice Address - Phone:417-581-1234
Practice Address - Fax:888-550-3518
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-28
Last Update Date:2014-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001014126225700000X
MO000971225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist