Healthcare Provider Details

I. General information

NPI: 1497693360
Provider Name (Legal Business Name): MICHELLE BARNES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2026
Last Update Date: 03/23/2026
Certification Date: 03/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 OLD FREDERICK RD
BALTIMORE MD
21228-4811
US

IV. Provider business mailing address

9140 LINKS RD
WALKERSVILLE MD
21793-9707
US

V. Phone/Fax

Practice location:
  • Phone: 240-405-7236
  • Fax:
Mailing address:
  • Phone: 240-405-7236
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License NumberA02923
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: