Individual provider · Type 1 NPI

Beverly Wallace, OTR/L

Occupational Therapist · Bradenton, FL

NPI number 1174595367 Active

Practice location

3911 Golf Park Loop, Suite #105
Bradenton, FL 34203-3453

Call (941) 756-1003 Map

Fax (941) 756-6003

Mailing address

6477 Indigo Bunting Pl
Bradenton, FL 34202-8246

Specialties and licenses

TaxonomyCodeLicense
Occupational Therapist Primary 225X00000XOT9730 (FL)

Occupational Therapist: An occupational therapist is a person who has graduated from an entry-level occupational therapy program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, or approved by the World Federation of Occupational Therapists (WFOT), or an equivalent international occupational therapy education program; has successfully completed a period of supervised fieldwork…

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About NPI 1174595367

Beverly Wallace, OTR/L's National Provider Identifier is 1174595367, issued on Feb 2, 2006. The primary taxonomy on file is Occupational Therapist (225X00000X), and the practice location is in Bradenton, FL. The record was last updated on Jul 13, 2026.