Healthcare Provider Details

I. General information

NPI: 1902725831
Provider Name (Legal Business Name): BAILEY BIDDULPH MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

640 S 80 E STE 110
LOGAN UT
84321-7090
US

IV. Provider business mailing address

640 S 80 E STE 110
LOGAN UT
84321-7090
US

V. Phone/Fax

Practice location:
  • Phone: 435-557-0234
  • Fax:
Mailing address:
  • Phone: 435-557-0234
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number5181620
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: