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NPI Code Detail

MEDICARE: CAROLYN BARTLETT O.T., C.H.T.

MEDICARE: CAROLYN BARTLETT O.T., C.H.T.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225XH1200XHand Occupational TherapistOT7196CA

General Provider Information

NPI Number : 1023176450
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAROLYN BARTLETT O.T., C.H.T.
Provider Business Mailing Address
First Line : 1405 MONTGOMERY DR
Second Line :
City : SANTA ROSA
State : CA
Zip : 95405-4557
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1405 MONTGOMERY DR
Second Line :
City : SANTA ROSA
State : CA
Zip : 95405-4557
Country : US
Telephone Number : 707-546-1922
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/05/2006
Last Update Date : 11/24/2010

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