Provider Demographics
NPI:1164113817
Name:DELEY, RYLEE ANNEMARIE (COTA/L)
Entity Type:Individual
Prefix:MRS
First Name:RYLEE
Middle Name:ANNEMARIE
Last Name:DELEY
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:MS
Other - First Name:RYLEE
Other - Middle Name:ANNEMARIE
Other - Last Name:GODARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:400 CRATER LAKE AVE
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504
Mailing Address - Country:US
Mailing Address - Phone:541-613-6505
Mailing Address - Fax:541-770-9212
Practice Address - Street 1:400 CRATER LAKE AVE
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504
Practice Address - Country:US
Practice Address - Phone:541-613-6505
Practice Address - Fax:541-770-9212
Is Sole Proprietor?:No
Enumeration Date:2023-05-15
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR427098224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant