Provider Demographics
NPI:1598529349
Name:BAILOR, EMILY (OTR)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:BAILOR
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:
Other - Last Name:ENGLEBACH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:121 MAN O WAR DR
Mailing Address - Street 2:
Mailing Address - City:OAK GROVE
Mailing Address - State:KY
Mailing Address - Zip Code:42262-9102
Mailing Address - Country:US
Mailing Address - Phone:828-460-4705
Mailing Address - Fax:
Practice Address - Street 1:235 MED PARK DR
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-6310
Practice Address - Country:US
Practice Address - Phone:931-538-3755
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7903225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist