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Individual

MARIAH KAY BARR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
6205 MINERAL POINT RD, MADISON, WI 53705-4576
(608) 230-4280
Mailing address
5441 KALESEY CT LOT 39, WAUNAKEE, WI 53597-9279
(618) 895-4228

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
057004404
IL
224Z00000X
Occupational Therapy Assistant
Primary
5442
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
057004404
OTA LICENSE
IL
01
5442
OTA LICENSE
WI
Enumeration date
06/21/2018
Last updated
06/21/2018
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