Healthcare Provider Details

I. General information

NPI: 1316865157
Provider Name (Legal Business Name): OT BESTIE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5815 N LYDELL AVE UNIT 524
GLENDALE WI
53217-4520
US

IV. Provider business mailing address

5815 N LYDELL AVE UNIT 524
GLENDALE WI
53217-4520
US

V. Phone/Fax

Practice location:
  • Phone: 978-319-1841
  • Fax:
Mailing address:
  • Phone: 978-319-1841
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: SYED ADEL ALI
Title or Position: FOUNDER/CEO
Credential:
Phone: 978-319-1841