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

Mrs. Beverly Wallace, OTR/L

Individual provider Occupational Therapist · NPI 1174595367

Mrs. Beverly Wallace, OTR/L is an Occupational Therapist in Bradenton, Florida. Licensed in Florida. Registered with an NPI since 2006.

Licensed in
FL
In the registry since
2006
What do these letters mean?
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

3911 Golf Park Loop Ste #105
Bradenton, FL 34203-3453
Phone: (941) 756-1003
Fax: (941) 756-6003
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Occupational Therapist (primary) Taxonomy 225X00000X · Licence OT9730 (FL)

Record details

NPI number1174595367
Entity typeIndividual (Type 1)
GenderFemale
Credentials OTR/L
Sole proprietorNo
NPI enumeratedFebruary 2, 2006
Last updated in NPPESJuly 13, 2026

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