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General NPI Number Information
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NPI Number | 1912059460
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Entity Type | Individual
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Provider Name | JAMIE BAILEY OTRL
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Gender | Female
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Dates
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Enumeration Date | 01/17/2007
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Last Update Date | 09/13/2007
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Provider Practice Location Address
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Address Line | 2740 COLLEGE AVENUE
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City | CONWAY
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State | AR
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Zip | 72034-9310
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Country | US
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Telephone | 501-329-5459
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Fax | 301-325-1378
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Provider Business Mailing Address
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Address Line | 2600 TJ DRIVE
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City | CONWAY
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State | AR
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Zip | 72034
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Country | US
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Telephone | 501-513-9089
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Fax |
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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 | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | OTR1518
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License Number State | AR
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