Healthcare Provider Details

I. General information

NPI: 1215840194
Provider Name (Legal Business Name): BAILEY VIEAU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 N 5TH ST
WEST MEMPHIS AR
72301-3213
US

IV. Provider business mailing address

415 BIRDIE DR APT 12
MARION AR
72364-1660
US

V. Phone/Fax

Practice location:
  • Phone: 706-473-5961
  • Fax:
Mailing address:
  • Phone: 763-923-5406
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License NumberN704109931811
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: