Provider Demographics
NPI:1740754647
Name:BAILEY, TERRI BERTHA (OTR/L, OTD)
Entity Type:Individual
Prefix:
First Name:TERRI
Middle Name:BERTHA
Last Name:BAILEY
Suffix:
Gender:F
Credentials:OTR/L, OTD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12000 OTHMAN CT
Mailing Address - Street 2:
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20744-6068
Mailing Address - Country:US
Mailing Address - Phone:301-404-1800
Mailing Address - Fax:
Practice Address - Street 1:12000 OTHMAN CT
Practice Address - Street 2:
Practice Address - City:FORT WASHINGTON
Practice Address - State:MD
Practice Address - Zip Code:20744-6068
Practice Address - Country:US
Practice Address - Phone:301-404-1800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-14
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01875225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist