MEDICARE: ANGEL RAE BAIL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker

General Provider Information

NPI Number	:	1881450435
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGEL RAE BAIL

Provider Business Mailing Address
First Line	:	606 S GORHAM ST
Second Line	:
City	:	JACKSON
State	:	MI
Zip	:	49203-2027
Country	:	US
Telephone Number	:	517-787-9887
Fax Number	:	517-787-1906

Provider Business Practice Location Address
First Line	:	2245 W PARNALL RD
Second Line	:
City	:	JACKSON
State	:	MI
Zip	:	49201-9000
Country	:	US
Telephone Number	:	517-787-9887
Fax Number	:	517-787-1906

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/22/2024
Last Update Date	:	02/29/2024

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Directions to “ ANGEL RAE BAIL ” Practice Location

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