MEDICARE: MS. MONIQUE ANITA BARKLEY-BRACKETT OTR

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
1	225X00000X	Occupational Therapist	111483	TX
2	225X00000X	Occupational Therapist	21691	CA
3	225X00000X	Occupational Therapist	OT-3377	NV

General Provider Information

NPI Number	:	1891035267
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MONIQUE ANITA BARKLEY-BRACKETT OTR

Provider Business Mailing Address
First Line	:	1650 LYNDON FARM CT STE 300
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40223-5005
Country	:	US
Telephone Number	:	951-335-9825
Fax Number	:	951-666-5096

Provider Business Practice Location Address
First Line	:	3920 W CHARLESTON BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-1631
Country	:	US
Telephone Number	:	877-757-8353
Fax Number	:	818-357-2505

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/22/2013
Last Update Date	:	04/27/2026

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