Provider Demographics
NPI:1811189640
Name:BARTLEY, TERRI ALICE (OTD, OTR/L)
Entity Type:Individual
Prefix:DR
First Name:TERRI
Middle Name:ALICE
Last Name:BARTLEY
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:138 LORETTA WAY
Mailing Address - Street 2:
Mailing Address - City:FOREST HILL
Mailing Address - State:MD
Mailing Address - Zip Code:21050-3028
Mailing Address - Country:US
Mailing Address - Phone:501-413-7892
Mailing Address - Fax:
Practice Address - Street 1:138 LORETTA WAY
Practice Address - Street 2:
Practice Address - City:FOREST HILL
Practice Address - State:MD
Practice Address - Zip Code:21050-3028
Practice Address - Country:US
Practice Address - Phone:501-413-7892
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-15
Last Update Date:2018-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROTR/L 1357225X00000X
MD06907225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AROTR/L 1357OtherOCCUPATIONAL THERAPIST #
MD06907OtherOCCUPATIONAL THERAPIST #