Healthcare Provider Details

I. General information

NPI: 1720926041
Provider Name (Legal Business Name): SEBASTIEN BARRETTE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/25/2026
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 NICHOLE LN
COVENTRY RI
02816-6310
US

IV. Provider business mailing address

17 NICHOLE LN
COVENTRY RI
02816-6310
US

V. Phone/Fax

Practice location:
  • Phone: 401-523-5354
  • Fax:
Mailing address:
  • Phone: 401-523-5354
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License NumberOTA01066
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: