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NPI Code Detail

MEDICARE: MAKENNA B BAILEY OT

MEDICARE: MAKENNA B BAILEY OT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational TherapistOT25679FL

General Provider Information

NPI Number : 1518780287
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAKENNA B BAILEY OT
Provider Business Mailing Address
First Line : 8259 WICKER AVE
Second Line :
City : SAINT JOHN
State : IN
Zip : 46373-8878
Country : US
Telephone Number : 740-275-4480
Fax Number :
Provider Business Practice Location Address
First Line : 3955 INDIAN RIVER BLVD
Second Line :
City : VERO BEACH
State : FL
Zip : 32960-4814
Country : US
Telephone Number : 772-257-3621
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2024
Last Update Date : 11/01/2024

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Directions to “ MAKENNA B BAILEY OT” Practice Location

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