Provider Demographics
NPI:1801962352
Name:DAILY, TERRAN HARCOURT (OTR L)
Entity type:Individual
Prefix:
First Name:TERRAN
Middle Name:HARCOURT
Last Name:DAILY
Suffix:
Gender:F
Credentials:OTR L
Other - Prefix:
Other - First Name:TERRAN
Other - Middle Name:TANKERSLEY
Other - Last Name:POTKIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1178 BEITH CT
Mailing Address - Street 2:
Mailing Address - City:ARCATA
Mailing Address - State:CA
Mailing Address - Zip Code:95521-6716
Mailing Address - Country:US
Mailing Address - Phone:707-601-1850
Mailing Address - Fax:
Practice Address - Street 1:1178 BEITH CT
Practice Address - Street 2:
Practice Address - City:ARCATA
Practice Address - State:CA
Practice Address - Zip Code:95521-6716
Practice Address - Country:US
Practice Address - Phone:707-601-1850
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-27
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT9008225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist