Healthcare Provider Details

I. General information

NPI: 1194228601
Provider Name (Legal Business Name): TYMI JEAN BAILEY BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/10/2018
Last Update Date: 04/19/2022
Certification Date: 04/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3680 S CEDAR ST STE A
TACOMA WA
98409-5728
US

IV. Provider business mailing address

3680 S CEDAR ST STE A
TACOMA WA
98409-5728
US

V. Phone/Fax

Practice location:
  • Phone: 253-289-9500
  • Fax: 206-641-9540
Mailing address:
  • Phone: 253-289-9500
  • Fax: 206-641-9540

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: