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NPI 1083961361

NPI 1083961361 : KATHLEEN MARIE BARBARO M.A. OTR/L : PASADENA, CA

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General NPI Number Information
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    NPI Number           |    1083961361
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    Entity Type          |    Individual 
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    Provider Name        |    KATHLEEN MARIE BARBARO M.A. OTR/L
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    08/06/2012
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    Last Update Date     |    08/06/2012
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Provider Practice Location Address
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    Address Line         |    200 E DEL MAR BLVD SUITE 112
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    City                 |    PASADENA
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    State                |    CA
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    Zip                  |    91105-2544
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    Country              |    US
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    Telephone            |    626-564-2700
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    Fax                  |    626-564-2770
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Provider Business Mailing Address
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    Address Line         |    2001 POLARIS DR 
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    City                 |    GLENDALE
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    State                |    CA
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    Zip                  |    91208-2426
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    Country              |    US
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    Telephone            |    818-802-6648
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    225X00000X
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    Taxonomy Name        |    Occupational Therapist
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    License Number       |    12816
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    License Number State |    CA
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