Provider Demographics
NPI:1922420181
Name:BARNETT, ANITA (OTR/L)
Entity Type:Individual
Prefix:
First Name:ANITA
Middle Name:
Last Name:BARNETT
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 1:3050 N NAVAJO DR
Mailing Address - Street 2:SUITE 110
Mailing Address - City:PRESCOTT VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:86314-8663
Mailing Address - Country:US
Mailing Address - Phone:928-772-5917
Mailing Address - Fax:928-771-9519
Practice Address - Street 1:3050 N NAVAJO DR
Practice Address - Street 2:SUITE 110
Practice Address - City:PRESCOTT VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:86314-8663
Practice Address - Country:US
Practice Address - Phone:928-772-5917
Practice Address - Fax:928-771-9519
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-07
Last Update Date:2015-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5397225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist