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General NPI Number Information
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NPI Number | 1275079204
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Entity Type | Individual
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Provider Name | AMBUR DAWN BAILEY
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Gender | Female
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Dates
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Enumeration Date | 01/14/2017
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Last Update Date | 02/13/2024
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Provider Practice Location Address
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Address Line | 41521 W 11 MILE RD
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City | NOVI
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State | MI
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Zip | 48375-1803
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Country | US
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Telephone | 248-299-0030
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Fax |
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Provider Business Mailing Address
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Address Line | 7169 SE RENADA ST
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City | MILWAUKIE
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State | OR
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Zip | 97267-3342
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Country | US
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Telephone | 35-248-8155
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Fax |
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | A14716
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License Number State | OR
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