MEDICARE: BAILEY SIEH OTRL

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
1	225X00000X	Occupational Therapist
2	225X00000X	Occupational Therapist	2651	NE

General Provider Information

NPI Number	:	1346976834
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BAILEY SIEH OTRL

Provider Business Mailing Address
First Line	:	11522 GERTRUDE PLZ APT 308
Second Line	:
City	:	LA VISTA
State	:	NE
Zip	:	68128-7705
Country	:	US
Telephone Number	:	402-213-1381
Fax Number	:

Provider Business Practice Location Address
First Line	:	955 N ADAMS ST STE 1
Second Line	:
City	:	PAPILLION
State	:	NE
Zip	:	68046-3080
Country	:	US
Telephone Number	:	531-600-7774
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/27/2022
Last Update Date	:	12/12/2023

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Directions to “ BAILEY SIEH OTRL” Practice Location

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