Provider Demographics
NPI:1902100506
Name:BAILEY, KATHERINE LEANN (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:LEANN
Last Name:BAILEY
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3749 MURDOCKSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:WEST END
Mailing Address - State:NC
Mailing Address - Zip Code:27376-8863
Mailing Address - Country:US
Mailing Address - Phone:813-758-2324
Mailing Address - Fax:
Practice Address - Street 1:300 W PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:SOUTHERN PINES
Practice Address - State:NC
Practice Address - Zip Code:28387-5445
Practice Address - Country:US
Practice Address - Phone:910-246-9882
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-22
Last Update Date:2013-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7095225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist