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General NPI Number Information
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NPI Number | 1518731850
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Entity Type | Individual
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Provider Name | ALESHA RAE BAILEY CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 11/07/2023
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Last Update Date | 11/07/2023
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Provider Practice Location Address
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Address Line | 4214 BIENVILLE BLVD
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City | OCEAN SPRINGS
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State | MS
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Zip | 39564-5975
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Country | US
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Telephone | 228-218-3362
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Fax | 228-366-9062
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Provider Business Mailing Address
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Address Line | 22011 NORTHVIEW DR
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City | MOSS POINT
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State | MS
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Zip | 39562-6842
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Country | US
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Telephone | 601-678-9001
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 5035
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License Number State | MS
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