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General NPI Number Information
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NPI Number | 1215280631
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Entity Type | Individual
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Provider Name | LAURA M BAILEY MS, LMFT
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Gender | Female
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Dates
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Enumeration Date | 10/23/2012
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Last Update Date | 10/31/2018
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Provider Practice Location Address
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Address Line | 3430 ROBIN LN STE 3A
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City | CAMERON PARK
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State | CA
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Zip | 95682-8441
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Country | US
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Telephone | 530-492-6957
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Fax | 530-387-5641
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Provider Business Mailing Address
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Address Line | PO BOX 668
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City | SHINGLE SPRINGS
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State | CA
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Zip | 95682-0668
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Country | US
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Telephone | 304-926-9575
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Fax | 530-387-5641
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 4101006496
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | LMFT86284
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License Number State | CA
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