Provider Demographics
NPI:1184070377
Name:STEVENS, BARBARA (0029351)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:STEVENS
Suffix:
Gender:F
Credentials:0029351
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 SARATOGA BRIDGES BLVD
Mailing Address - Street 2:
Mailing Address - City:BALLSTON SPA
Mailing Address - State:NY
Mailing Address - Zip Code:12020-6236
Mailing Address - Country:US
Mailing Address - Phone:518-587-0723
Mailing Address - Fax:518-583-9607
Practice Address - Street 1:16 SARATOGA BRIDGES BLVD
Practice Address - Street 2:
Practice Address - City:BALLSTON SPA
Practice Address - State:NY
Practice Address - Zip Code:12020-6236
Practice Address - Country:US
Practice Address - Phone:518-587-0723
Practice Address - Fax:518-583-9607
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-06
Last Update Date:2016-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0029351224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0029351OtherTHE UNIVERSITY OF THE STATE OF NEW YORK EDUCATION DEPT. OFFICE OF PROFESSIONS