Provider Demographics
NPI:1881836468
Name:BARRETT, PATRICIA ANN (ATP RET)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:ANN
Last Name:BARRETT
Suffix:
Gender:F
Credentials:ATP RET
Other - Prefix:
Other - First Name:PATTI
Other - Middle Name:ANN
Other - Last Name:BARRETT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ATP RET
Mailing Address - Street 1:4213 RABBIT POND RD
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32309-6437
Mailing Address - Country:US
Mailing Address - Phone:850-294-1606
Mailing Address - Fax:866-433-2228
Practice Address - Street 1:4213 RABBIT POND RD
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32309-6437
Practice Address - Country:US
Practice Address - Phone:850-294-1606
Practice Address - Fax:866-433-2228
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-30
Last Update Date:2014-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLATP RET225400000X, 225CA2400X, 225XE0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
No225CA2400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation CounselorAssistive Technology Practitioner
No225XE0001XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistEnvironmental Modification
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL6912702 79Medicaid
FL6912702 96Medicaid
FL6912702 96Medicaid