Healthcare Provider Details

I. General information

NPI: 1700818911
Provider Name (Legal Business Name): REBECCA BAILEY PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 04/14/2026
Certification Date: 04/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5770 S 250 E STE 135
MURRAY UT
84107-8241
US

IV. Provider business mailing address

PO BOX 27128
SALT LAKE CITY UT
84127-0128
US

V. Phone/Fax

Practice location:
  • Phone: 801-314-5500
  • Fax:
Mailing address:
  • Phone: 801-314-5500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number115659-2501
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number1156592501
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: