Provider Demographics
NPI:1598352148
Name:BARRETT, LAURA MARIE (COTA/L)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:MARIE
Last Name:BARRETT
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DOVER FOXCROFT
Mailing Address - State:ME
Mailing Address - Zip Code:04426-1246
Mailing Address - Country:US
Mailing Address - Phone:207-564-3463
Mailing Address - Fax:207-564-3900
Practice Address - Street 1:207 E MAIN ST
Practice Address - Street 2:
Practice Address - City:DOVER FOXCROFT
Practice Address - State:ME
Practice Address - Zip Code:04426-1246
Practice Address - Country:US
Practice Address - Phone:207-564-3463
Practice Address - Fax:207-564-3900
Is Sole Proprietor?:No
Enumeration Date:2020-12-30
Last Update Date:2020-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOA3560224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant