Provider Demographics
NPI:1336587955
Name:BAILEY, MONICA R (OTR/L)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:R
Last Name:BAILEY
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:MONICA
Other - Middle Name:R
Other - Last Name:DEAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:1900 MIDLAND TRL
Mailing Address - Street 2:SUITE 1 & 2
Mailing Address - City:SHELBYVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40065-8141
Mailing Address - Country:US
Mailing Address - Phone:502-633-1007
Mailing Address - Fax:
Practice Address - Street 1:6900 S ORANGE BLOSSOM TRL STE 102
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32809-5734
Practice Address - Country:US
Practice Address - Phone:321-445-1287
Practice Address - Fax:407-386-7448
Is Sole Proprietor?:No
Enumeration Date:2013-06-05
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT18076225XP0200X
KYR5443225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist