Provider Demographics
NPI:1366168379
Name:BARTLEIN, JEANNIE MARIE (OT)
Entity type:Individual
Prefix:
First Name:JEANNIE
Middle Name:MARIE
Last Name:BARTLEIN
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2211 E FRANKLIN BLVD
Mailing Address - Street 2:SUITE 100A
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054-4985
Mailing Address - Country:US
Mailing Address - Phone:704-852-9561
Mailing Address - Fax:
Practice Address - Street 1:2211 E FRANKLIN BLVD STE 100A
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-4986
Practice Address - Country:US
Practice Address - Phone:704-852-9561
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-12
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5893225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand