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General NPI Number Information
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NPI Number | 1942922778
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Entity Type | Organization
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Legal Business Name | BRIANNA J. BAILEY PLLC
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Dates
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Enumeration Date | 09/19/2022
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Last Update Date | 09/19/2022
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Provider Practice Location Address
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Address Line | 3360 RILEY THOMPSON RD
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City | WHITEHALL
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State | MI
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Zip | 49461-9730
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Country | US
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Telephone | 440-429-3575
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Fax |
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Provider Business Mailing Address
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Address Line | 3360 RILEY THOMPSON RD
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City | WHITEHALL
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State | MI
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Zip | 49461-9730
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Country | US
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Telephone | 440-429-3575
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST/OWNER
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Name | BRIANNA J BAILEY
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Credential | LLP
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Telephone | 440-429-3575
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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