Healthcare Provider Details

I. General information

NPI: 1942894654
Provider Name (Legal Business Name): BAILEY NICOLE HUNT MT-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2021
Last Update Date: 02/23/2021
Certification Date: 02/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5950 CROOKED CREEK RD STE 150Q
PEACHTREE CORNERS GA
30092-6216
US

IV. Provider business mailing address

5189 WELLSHIRE PL
ATLANTA GA
30338-3425
US

V. Phone/Fax

Practice location:
  • Phone: 404-510-3799
  • Fax:
Mailing address:
  • Phone: 770-262-6242
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: