Provider Demographics
NPI:1366006082
Name:BARRETT, SHALEEN
Entity type:Individual
Prefix:
First Name:SHALEEN
Middle Name:
Last Name:BARRETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 OAKWOOD LN
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:CT
Mailing Address - Zip Code:06237-1016
Mailing Address - Country:US
Mailing Address - Phone:860-377-4644
Mailing Address - Fax:
Practice Address - Street 1:55 OAKWOOD LN
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:CT
Practice Address - Zip Code:06237-1016
Practice Address - Country:US
Practice Address - Phone:860-377-4644
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-29
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT005373225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist