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General NPI Number Information
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NPI Number | 1336020676
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Entity Type | Individual
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Provider Name | BAILEY MIPRO BCBA
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Gender | Female
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Dates
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Enumeration Date | 09/11/2025
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 31 INDUSTRIAL PARK BLVD
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City | PONCHATOULA
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State | LA
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Zip | 70454-8303
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Country | US
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Telephone | 985-370-2300
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Fax |
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Provider Business Mailing Address
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Address Line | 102 LAKEWOOD ESTATES DR
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City | NEW ORLEANS
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State | LA
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Zip | 70131-8300
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Country | US
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Telephone | 504-615-5196
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-25-83797
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License Number State | LA
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