Provider Demographics
NPI:1558171868
Name:HALL, BAYLEE NICOLE RYAN
Entity type:Individual
Prefix:
First Name:BAYLEE
Middle Name:NICOLE RYAN
Last Name:HALL
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3903 N HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:OK
Mailing Address - Zip Code:74804-1426
Mailing Address - Country:US
Mailing Address - Phone:405-585-2971
Mailing Address - Fax:405-585-2983
Practice Address - Street 1:3903 N HARRISON ST
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:OK
Practice Address - Zip Code:74804-1426
Practice Address - Country:US
Practice Address - Phone:405-585-2971
Practice Address - Fax:405-585-2983
Is Sole Proprietor?:No
Enumeration Date:2025-01-09
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK6052225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics