Provider Demographics
NPI:1891275178
Name:BARRETT, ANGELA RESHAI (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:RESHAI
Last Name:BARRETT
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 1:39 FERNDALE APARTMENTS RD
Mailing Address - Street 2:
Mailing Address - City:PINEVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40977-8578
Mailing Address - Country:US
Mailing Address - Phone:606-337-2907
Mailing Address - Fax:
Practice Address - Street 1:39 FERNDALE APARTMENTS RD
Practice Address - Street 2:
Practice Address - City:PINEVILLE
Practice Address - State:KY
Practice Address - Zip Code:40977-8578
Practice Address - Country:US
Practice Address - Phone:606-337-2907
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-16
Last Update Date:2018-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY134199225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist