Basic Information
Provider Information
NPI: 1649286964
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HALE
FirstName: BARBARA
MiddleName: H
NamePrefix:  
NameSuffix:  
Credential: OTRL
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5250 W. ANDREW JOHNSON HWY.
Address2:  
City: MORRISTOWN
State: TN
PostalCode: 378141027
CountryCode: US
TelephoneNumber: 4233187800
FaxNumber: 4233173332
Practice Location
Address1: 5250 W. ANDREW JOHNSON HWY.
Address2:  
City: MORRISTOWN
State: TN
PostalCode: 378141027
CountryCode: US
TelephoneNumber: 4237484800
FaxNumber: 4235855889
Other Information
ProviderEnumerationDate: 07/31/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225X00000X00029TNY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 

No ID Information.


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