Healthcare Provider Details

I. General information

NPI: 1255369583
Provider Name (Legal Business Name): BARBARA ANN BAILEY MS, RD, LD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2006
Last Update Date: 02/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

712 SUNSET DR
LISBON OH
44432-1044
US

IV. Provider business mailing address

712 SUNSET DR
LISBON OH
44432-1044
US

V. Phone/Fax

Practice location:
  • Phone: 330-424-5006
  • Fax:
Mailing address:
  • Phone: 330-424-5006
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberLD3087
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: