Healthcare Provider Details

I. General information

NPI: 1265378509
Provider Name (Legal Business Name): BRITTANY BAILEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 WESTWOOD DR
BECKLEY WV
25801-4247
US

IV. Provider business mailing address

201 WESTWOOD DR
BECKLEY WV
25801-4247
US

V. Phone/Fax

Practice location:
  • Phone: 304-719-7144
  • Fax:
Mailing address:
  • Phone: 304-719-7144
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: