Provider Demographics
NPI:1912155433
Name:BARNETT, CAROLYN RENEE (MS OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:CAROLYN
Middle Name:RENEE
Last Name:BARNETT
Suffix:
Gender:F
Credentials:MS OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1005 KNOLL DR
Mailing Address - Street 2:
Mailing Address - City:ENDICOTT
Mailing Address - State:NY
Mailing Address - Zip Code:13760-1911
Mailing Address - Country:US
Mailing Address - Phone:607-785-2123
Mailing Address - Fax:
Practice Address - Street 1:23 W GLANN RD
Practice Address - Street 2:
Practice Address - City:APALACHIN
Practice Address - State:NY
Practice Address - Zip Code:13732-4026
Practice Address - Country:US
Practice Address - Phone:607-725-0889
Practice Address - Fax:607-625-4251
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-09
Last Update Date:2015-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015339-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist