Provider Demographics
NPI:1659568814
Name:BARNES, LAUREN B (COTA)
Entity Type:Individual
Prefix:MS
First Name:LAUREN
Middle Name:B
Last Name:BARNES
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 LIONS LN
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:ME
Mailing Address - Zip Code:04843-1536
Mailing Address - Country:US
Mailing Address - Phone:207-236-7812
Mailing Address - Fax:
Practice Address - Street 1:7 LIONS LN
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:ME
Practice Address - Zip Code:04843-1536
Practice Address - Country:US
Practice Address - Phone:207-236-7812
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-01
Last Update Date:2014-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOA355224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEOA355OtherSTATE LICENSE