Provider Demographics
NPI:1538383252
Name:SMITH-BAYLEY, NANCY ANN (OTRL)
Entity type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:ANN
Last Name:SMITH-BAYLEY
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:438 BROOKSIDE DR
Mailing Address - Street 2:
Mailing Address - City:PERKASIE
Mailing Address - State:PA
Mailing Address - Zip Code:18944-2464
Mailing Address - Country:US
Mailing Address - Phone:215-262-5645
Mailing Address - Fax:
Practice Address - Street 1:438 BROOKSIDE DR
Practice Address - Street 2:
Practice Address - City:PERKASIE
Practice Address - State:PA
Practice Address - Zip Code:18944-2464
Practice Address - Country:US
Practice Address - Phone:215-262-5645
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2015-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC001493L225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001932803OtherMPI NUMBER