Provider Demographics
NPI:1821113812
Name:BARRETT, JAMES LEE (MS,LRT,CTRS)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:LEE
Last Name:BARRETT
Suffix:
Gender:M
Credentials:MS,LRT,CTRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3220 PORTERTOWN RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-7108
Mailing Address - Country:US
Mailing Address - Phone:252-847-4445
Mailing Address - Fax:252-847-8592
Practice Address - Street 1:2100 STANTONSBURG RD
Practice Address - Street 2:RECREATION THERAPY DEPARTMENT
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-2818
Practice Address - Country:US
Practice Address - Phone:252-847-4445
Practice Address - Fax:252-847-8592
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC003225800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist