Provider Demographics
NPI:1639763907
Name:MITCHELL, BAILEY GRAGG (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:BAILEY
Middle Name:GRAGG
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MS
Other - First Name:BAILEY
Other - Middle Name:LAUREL
Other - Last Name:GRAGG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:122 WHISPERING PINE ST
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28655-8281
Mailing Address - Country:US
Mailing Address - Phone:828-448-8075
Mailing Address - Fax:
Practice Address - Street 1:1880 N CENTER ST
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28601-1853
Practice Address - Country:US
Practice Address - Phone:828-322-7826
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-26
Last Update Date:2021-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13073225XP0200X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics