Provider Demographics
NPI:1336390723
Name:OLHSON-BARRY, JUDITH ANN (COTA/L)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:ANN
Last Name:OLHSON-BARRY
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7664 CURRIER RD
Mailing Address - Street 2:
Mailing Address - City:LOUDON
Mailing Address - State:NH
Mailing Address - Zip Code:03307-1314
Mailing Address - Country:US
Mailing Address - Phone:603-783-4290
Mailing Address - Fax:
Practice Address - Street 1:325 DANIEL WEBSTER HWY
Practice Address - Street 2:
Practice Address - City:BOSCAWEN
Practice Address - State:NH
Practice Address - Zip Code:03303-2410
Practice Address - Country:US
Practice Address - Phone:603-269-5161
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-04
Last Update Date:2008-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0408224Z00000X
MA2009224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant