Healthcare Provider Details

I. General information

NPI: 1225115819
Provider Name (Legal Business Name): DEBORAH S DAILEY OTR/L, CLT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DANIELLE DAILEY OTR/L, CLT

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 10/28/2024
Certification Date: 10/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3601 CIMARRON PLZ STE 105
HASTINGS NE
68901-2883
US

IV. Provider business mailing address

PO BOX 5285
GRAND ISLAND NE
68802-5285
US

V. Phone/Fax

Practice location:
  • Phone: 402-463-2077
  • Fax: 402-463-2062
Mailing address:
  • Phone: 308-675-1853
  • Fax: 308-210-4121

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number1511
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number628
License Number StateNE
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number8538
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT-1497
License Number StateWY
# 5
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number3921
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: