Healthcare Provider Details

I. General information

NPI: 1740755859
Provider Name (Legal Business Name): BAYLI BRIANNE MCCLARY CLC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/04/2018
Last Update Date: 09/19/2025
Certification Date: 09/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

529 E STROOP RD
DAYTON OH
45429-3245
US

IV. Provider business mailing address

3130 SUDBURY ST
SPRINGFIELD OH
45503-1729
US

V. Phone/Fax

Practice location:
  • Phone: 544-928-7954
  • Fax:
Mailing address:
  • Phone: 765-517-2235
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License NumberALPP-353162
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: