Provider Demographics
NPI:1447534326
Name:WEAS, BARBARA JEAN (OTR)
Entity type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:JEAN
Last Name:WEAS
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:JEAN
Other - Last Name:ZEISE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7540 N 19TH AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85021-7967
Mailing Address - Country:US
Mailing Address - Phone:602-324-6500
Mailing Address - Fax:
Practice Address - Street 1:1221 DURSTON RD
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-2725
Practice Address - Country:US
Practice Address - Phone:406-582-3300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-10
Last Update Date:2011-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1136225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT1136OtherSTATE OF MT, DEPARTMENT OF LABOR AND INDUSTRY
AA561639OtherNATIONAL BOARD OF CERTIFICATION ON OCCUPATIONAL THERAPY, INC.