Provider Demographics
NPI:1194405548
Name:HAY, BAILEY B (MOTS, LOTR)
Entity type:Individual
Prefix:
First Name:BAILEY
Middle Name:B
Last Name:HAY
Suffix:
Gender:F
Credentials:MOTS, LOTR
Other - Prefix:
Other - First Name:BAILEY
Other - Middle Name:
Other - Last Name:BROUSSARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11140 N HARRELLS FERRY RD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-8307
Mailing Address - Country:US
Mailing Address - Phone:225-272-0150
Mailing Address - Fax:
Practice Address - Street 1:11140 N HARRELLS FERRY RD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816-8307
Practice Address - Country:US
Practice Address - Phone:225-272-0150
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-20
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA336619225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist