Provider Demographics
NPI:1275308629
Name:JEREB, BAILEY (OTR/L)
Entity Type:Individual
Prefix:
First Name:BAILEY
Middle Name:
Last Name:JEREB
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 1:4040 PLUM CREEK DR
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-8719
Mailing Address - Country:US
Mailing Address - Phone:281-229-4245
Mailing Address - Fax:
Practice Address - Street 1:4356 24TH STREET RD
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634-3330
Practice Address - Country:US
Practice Address - Phone:970-702-7400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-15
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOT.0008156225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist