Provider Demographics
NPI:1659913994
Name:BARRICK, COURTNEY MORIAH (OTR/L)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:MORIAH
Last Name:BARRICK
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:COURTNEY
Other - Middle Name:MORIAH
Other - Last Name:ZINT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:201 PARK ST
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42101-1708
Mailing Address - Country:US
Mailing Address - Phone:270-796-4698
Mailing Address - Fax:270-782-3274
Practice Address - Street 1:165 NATCHEZ TRACE AVE STE 200
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42103-7947
Practice Address - Country:US
Practice Address - Phone:270-796-4698
Practice Address - Fax:270-782-3274
Is Sole Proprietor?:No
Enumeration Date:2019-10-08
Last Update Date:2022-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY260303225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist