Provider Demographics
NPI:1487220463
Name:BROWNING, BAILEY LYN (COTA/L)
Entity Type:Individual
Prefix:
First Name:BAILEY
Middle Name:LYN
Last Name:BROWNING
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11208 QUAILS BLUFF CIR
Mailing Address - Street 2:
Mailing Address - City:LAKE WALES
Mailing Address - State:FL
Mailing Address - Zip Code:33853-2661
Mailing Address - Country:US
Mailing Address - Phone:863-532-2772
Mailing Address - Fax:
Practice Address - Street 1:11208 QUAILS BLUFF CIR
Practice Address - Street 2:
Practice Address - City:LAKE WALES
Practice Address - State:FL
Practice Address - Zip Code:33853-2661
Practice Address - Country:US
Practice Address - Phone:863-532-2772
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-01
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOTA17654225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLOTA17654OtherOCCUPATIONAL THERAPY ASSISTANT