Individual
MRS. LISA JAE BAILEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT/L
Contact information
Practice address
1045 WHIPPLE ST, PRESCOTT, AZ 86305-1662
(805) 287-2944
Mailing address
1403 W IRON SPRINGS RD LOT 64, PRESCOTT, AZ 86305-3308
(480) 528-7294
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2413
AZ
Other
Enumeration date
09/22/2009
Last updated
08/06/2020
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