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NPI Code Detail

MEDICARE: TINA DENISE BARNES COTA/L

MEDICARE: TINA DENISE BARNES COTA/L
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1224Z00000XOccupational Therapy AssistantOTA001130GA

General Provider Information

NPI Number : 1598497992
Entity Type Code : Individual
Provider Name (Legal Business Name) : TINA DENISE BARNES COTA/L
Provider Business Mailing Address
First Line : 1218 CRESTMARK BLVD
Second Line :
City : LITHIA SPRINGS
State : GA
Zip : 30122-4426
Country : US
Telephone Number : 478-697-6949
Fax Number :
Provider Business Practice Location Address
First Line : 156 PINE KNOLL DR
Second Line :
City : CARROLLTON
State : GA
Zip : 30117-2451
Country : US
Telephone Number : 770-832-8243
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/26/2022
Last Update Date : 06/26/2022

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Directions to “ TINA DENISE BARNES COTA/L” Practice Location

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