MEDICARE: MONIKA MARIA BAILEY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	SP00701	RI

General Provider Information

NPI Number	:	1073390746
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MONIKA MARIA BAILEY

Provider Business Mailing Address
First Line	:	2214 PROVIDENCE PIKE
Second Line	:
City	:	NORTH SMITHFIELD
State	:	RI
Zip	:	02896-9338
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2214 PROVIDENCE PIKE
Second Line	:
City	:	NORTH SMITHFIELD
State	:	RI
Zip	:	02896-9338
Country	:	US
Telephone Number	:	401-769-5492
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/14/2023
Last Update Date	:	09/14/2023

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Directions to “ MONIKA MARIA BAILEY ” Practice Location

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