Individual
NICOLE DAWN BAILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
505 BROADWAY ST, BARABOO, WI 53913-2183
(608) 524-7912
(608) 524-7990
Mailing address
333 ARLINGTON CT, SPRING GREEN, WI 53588-8727
(608) 588-7964
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3871-026
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40903400
—
WI
Enumeration date
04/03/2007
Last updated
07/09/2007
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