Provider Demographics
NPI:1780974766
Name:BURNWORTH, TORI BAILEY (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:TORI
Middle Name:BAILEY
Last Name:BURNWORTH
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:TORI
Other - Middle Name:BETH
Other - Last Name:BAILEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1750 W. 4TH STREET
Mailing Address - Street 2:OCC MED THERAPY DEPT.
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44906
Mailing Address - Country:US
Mailing Address - Phone:419-526-8567
Mailing Address - Fax:419-526-8151
Practice Address - Street 1:1750 W. 4TH STREET
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44906
Practice Address - Country:US
Practice Address - Phone:419-526-8567
Practice Address - Fax:419-526-8151
Is Sole Proprietor?:No
Enumeration Date:2011-04-12
Last Update Date:2011-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH007459225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation