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General NPI Number Information
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NPI Number | 1770819815
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Entity Type | Organization
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Legal Business Name | CHRISTINE B. BAILEY, PH.D., PC
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Dates
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Enumeration Date | 10/24/2009
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Last Update Date | 04/17/2025
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Provider Practice Location Address
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Address Line | 305 MAGNOLIA ST
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City | NEW SMYRNA BEACH
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State | FL
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Zip | 32168-7144
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Country | US
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Telephone | 386-732-7861
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Fax |
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Provider Business Mailing Address
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Address Line | 305 MAGNOLIA ST
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City | NEW SMYRNA BEACH
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State | FL
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Zip | 32168-7144
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Country | US
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Telephone | 386-732-7861
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Fax | 386-310-0571
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Authorized Official
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Title or Position | NEUROPSYCHOLOGIST
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Name | CHRISTINE B BAILEY
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Credential | PHD
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Telephone | 386-732-7861
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 1402
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License Number State | AL
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