Provider Demographics
NPI:1033419031
Name:BAILEY, LESLEY ANN DAWN (OTR/L)
Entity Type:Individual
Prefix:
First Name:LESLEY ANN
Middle Name:DAWN
Last Name:BAILEY
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1431 S CAROLINA AVE SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20003-2329
Mailing Address - Country:US
Mailing Address - Phone:202-669-8990
Mailing Address - Fax:
Practice Address - Street 1:1431 S CAROLINA AVE SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20003-2329
Practice Address - Country:US
Practice Address - Phone:202-669-8990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-25
Last Update Date:2010-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC702225X00000X
MD03525225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist