Provider Demographics
NPI:1053779983
Name:EBENSTEIN, BARBARA (MSOT/L)
Entity type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:
Last Name:EBENSTEIN
Suffix:
Gender:F
Credentials:MSOT/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 DEER CREEK LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VT
Mailing Address - Zip Code:05477-9423
Mailing Address - Country:US
Mailing Address - Phone:802-434-2652
Mailing Address - Fax:
Practice Address - Street 1:51 DEER CREEK LN
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VT
Practice Address - Zip Code:05477-9423
Practice Address - Country:US
Practice Address - Phone:802-434-2652
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-06
Last Update Date:2016-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT072.0000010225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics