Provider Demographics
NPI:1831464163
Name:BARRY, LEORA A (OTR/L)
Entity Type:Individual
Prefix:
First Name:LEORA
Middle Name:A
Last Name:BARRY
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:168 SHEA AVE
Mailing Address - Street 2:
Mailing Address - City:BELCHERTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:01007-9329
Mailing Address - Country:US
Mailing Address - Phone:802-272-2013
Mailing Address - Fax:
Practice Address - Street 1:168 SHEA AVE
Practice Address - Street 2:
Practice Address - City:BELCHERTOWN
Practice Address - State:MA
Practice Address - Zip Code:01007-9329
Practice Address - Country:US
Practice Address - Phone:802-272-2013
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-20
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10413225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist