Provider Demographics
NPI:1346976834
Name:SIEH, BAILEY (OTRL)
Entity type:Individual
Prefix:
First Name:BAILEY
Middle Name:
Last Name:SIEH
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 1:11522 GERTRUDE PLZ APT 308
Mailing Address - Street 2:
Mailing Address - City:LA VISTA
Mailing Address - State:NE
Mailing Address - Zip Code:68128-7705
Mailing Address - Country:US
Mailing Address - Phone:402-213-1381
Mailing Address - Fax:
Practice Address - Street 1:955 N ADAMS ST STE 1
Practice Address - Street 2:
Practice Address - City:PAPILLION
Practice Address - State:NE
Practice Address - Zip Code:68046-3080
Practice Address - Country:US
Practice Address - Phone:531-600-7774
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-27
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225X00000X
NE2651225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist