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General NPI Number Information
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NPI Number | 1043445018
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Entity Type | Individual
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Provider Name | TARA LYNN BAILEY MOT, OTR/L
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Gender | Female
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Dates
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Enumeration Date | 05/20/2009
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1020 ARLINGTON ST
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City | ADA
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State | OK
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Zip | 74820-4037
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Country | US
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Telephone | 580-427-9040
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Fax | 580-427-9040
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Provider Business Mailing Address
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Address Line | PO BOX 596
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City | ADA
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State | OK
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Zip | 74821-0596
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Country | US
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Telephone | 580-427-9040
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Fax | 580-427-9040
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 1758
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License Number State | OK
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