Provider Demographics
NPI:1982359477
Name:PRITCHARD, BAYLEE NICOLE (OT)
Entity type:Individual
Prefix:
First Name:BAYLEE
Middle Name:NICOLE
Last Name:PRITCHARD
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:BAYLEE
Other - Middle Name:NICOLE
Other - Last Name:STOLL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:405 MONROE ST
Mailing Address - Street 2:
Mailing Address - City:PELLA
Mailing Address - State:IA
Mailing Address - Zip Code:50219-1189
Mailing Address - Country:US
Mailing Address - Phone:641-628-3150
Mailing Address - Fax:641-628-7241
Practice Address - Street 1:2525 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:PELLA
Practice Address - State:IA
Practice Address - Zip Code:50219-1553
Practice Address - Country:US
Practice Address - Phone:641-628-6728
Practice Address - Fax:641-628-6727
Is Sole Proprietor?:No
Enumeration Date:2022-02-14
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA109458225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA109458OtherSTATE LICENSE