Provider Demographics
NPI:1083395529
Name:MILLER, PAYTON BAILEY (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:PAYTON
Middle Name:BAILEY
Last Name:MILLER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MISS
Other - First Name:PAYTON
Other - Middle Name:BAILEY
Other - Last Name:WILMOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5018 OLD HIGHWAY 40
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:MO
Mailing Address - Zip Code:64076-6326
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5018 OLD HIGHWAY 40
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:MO
Practice Address - Zip Code:64076-6326
Practice Address - Country:US
Practice Address - Phone:816-352-8437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-27
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist