De'Von A Bailey, COTA

Individual provider Active NPI Occupational Therapy Assistant · Tulsa, OK

NPI 1720525975 · NPPES record last updated Jan 26, 2017

Key facts

NPI
1720525975
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
1763 (OK)
Practice address
5409 E 71St St Apt 18
Tulsa, OK 74136-6250
Phone
(918) 497-1068
Fax
(918) 497-1069
NPI assigned
Jan 26, 2017
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 1763 OK Yes

Addresses

Primary practice location

5409 E 71St St Apt 18
Tulsa, OK 74136-6250

Mailing address

5409 E 71St Apt 18
5800 E Skelly Dr Suit 402
Tulsa, OK 74136
Phone (918) 497-1068

Other providers in Tulsa, OK

All providers in Tulsa, OK · Occupational Therapy Assistant in Oklahoma

Sources for this page

Verify at the official NPI Registry.