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General NPI Number Information
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NPI Number | 1508625054
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Entity Type | Individual
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Provider Name | ANTONELLA BARECANTE OTD, OR/L
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Gender | Female
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Dates
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Enumeration Date | 03/18/2024
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Last Update Date | 03/18/2024
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Provider Practice Location Address
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Address Line | 1012 S 3RD ST
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City | DAYTON
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State | WA
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Zip | 99328-1606
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Country | US
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Telephone | 509-382-2531
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Fax |
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Provider Business Mailing Address
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Address Line | 7204 SWEETGRASS BLVD
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City | HANAHAN
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State | SC
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Zip | 29410-4702
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Country | US
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Telephone |
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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 |
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License Number State |
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