Healthcare Provider Details

I. General information

NPI: 1841108297
Provider Name (Legal Business Name): ILLIYANA CAROLYN BAILEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3785 BAKER LN STE 201
RENO NV
89509-5454
US

IV. Provider business mailing address

920 EVANS AVE # 437
RENO NV
89512-2805
US

V. Phone/Fax

Practice location:
  • Phone: 725-207-4744
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: