Provider Demographics
NPI:1073912598
Name:BAGBY, GAIL (OCCUPATIONAL THERAPY)
Entity Type:Individual
Prefix:MRS
First Name:GAIL
Middle Name:
Last Name:BAGBY
Suffix:
Gender:F
Credentials:OCCUPATIONAL THERAPY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 FRANK RICHARDSON CT
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95823-5410
Mailing Address - Country:US
Mailing Address - Phone:916-681-1913
Mailing Address - Fax:916-423-5957
Practice Address - Street 1:100 FRANK RICHARDSON CT
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823-5410
Practice Address - Country:US
Practice Address - Phone:916-681-1913
Practice Address - Fax:916-423-5957
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-20
Last Update Date:2014-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OT3904225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand