Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dalton Frederick, OTD, OTR/L

Individual provider Occupational Therapist · NPI 1811776701

Dalton Frederick, OTD, OTR/L is an Occupational Therapist in Private Practice in Vancleave, Mississippi. Graduated from University of Mississippi School of Medicine in 2023, 3 years ago. Practices with Bienville Therapy, LLC, a 25-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Mississippi.

Years since qualifying
3
Trained at
University of Mississippi School of Medicine
Licensed in
MS
In the registry since
2023
What do these letters mean?
OTD — Doctor of Occupational Therapy
The doctoral degree in occupational therapy.
OTR/L — Occupational Therapist, Registered and Licensed
An occupational therapist who is both nationally registered and state licensed.

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Practice location Address checks out

6300 E Lake Blvd Ste 101
Vancleave, MS 39565-6771
Phone: (228) 215-2240
Fax: (228) 215-2241
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 15476 Dedeaux Rd Ste A, Gulfport, MS 39503-2637 — (228) 215-0700

Specialties & licences

Occupational Therapist (primary) Taxonomy 225X00000X · Licence OT-4052 (MS)

Record details

NPI number1811776701
Entity typeIndividual (Type 1)
GenderMale
Credentials OTD , OTR/L
Sole proprietorNo
NPI enumeratedSeptember 28, 2023
Last updated in NPPESAugust 22, 2024
Certification dateAugust 22, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOCCUPATIONAL THERAPIST IN PRIVATE PRACTICE
Medical schoolUNIVERSITY OF MISSISSIPPI SCHOOL OF MEDICINE
Graduated 2023 (3 years in practice)
Group practice Bienville Therapy, Llc — 25 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Vancleave