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General NPI Number Information
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NPI Number | 1619202090
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Entity Type | Individual
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Provider Name | BARBARA ANN PAULGER C.O.T,A.
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Gender | Female
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Dates
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Enumeration Date | 10/02/2009
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Last Update Date | 10/02/2009
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Provider Practice Location Address
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Address Line | 7300 OLEANDER AVE
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City | PORT SAINT LUCIE
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State | FL
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Zip | 34952-8221
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Country | US
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Telephone | 772-464-7346
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Fax |
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Provider Business Mailing Address
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Address Line | 225 PEACOCK ST
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City | FORT PIERCE
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State | FL
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Zip | 34982-6313
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Country | US
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Telephone | 772-460-9369
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 0TA 7336
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License Number State | FL
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