Healthcare Provider Details

I. General information

NPI: 1003748849
Provider Name (Legal Business Name): BAILEY SWEET-WILKINS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 N KINGS HWY STE A
MYRTLE BEACH SC
29577-3946
US

IV. Provider business mailing address

2117 BUXTON DR
MYRTLE BEACH SC
29579-6677
US

V. Phone/Fax

Practice location:
  • Phone: 800-701-0498
  • Fax:
Mailing address:
  • Phone: 607-372-1199
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number12688694
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: