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General NPI Number Information
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NPI Number | 1831980374
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Entity Type | Individual
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Provider Name | JESSICA BAILEY
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Gender | Female
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Dates
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Enumeration Date | 05/14/2025
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Last Update Date | 05/14/2025
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Provider Practice Location Address
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Address Line | 1320 MAIN ST STE 300
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City | COLUMBIA
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State | SC
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Zip | 29201-3266
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Country | US
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Telephone | 877-418-2978
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Fax |
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Provider Business Mailing Address
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Address Line | 2209 BOWEN CORNER AVE
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City | HANAHAN
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State | SC
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Zip | 29410
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Country | US
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Telephone | 803-572-6398
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State | SC
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