MEDICARE: BAILEY SCACCHI RBT

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	106S00000X	Behavior Technician	RBT-21-189848	OH

General Provider Information

NPI Number	:	1114680659
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BAILEY SCACCHI RBT

Provider Business Mailing Address
First Line	:	3570 WARRENSVILLE CENTER RD STE 106
Second Line	:
City	:	SHAKER HTS
State	:	OH
Zip	:	44122-5226
Country	:	US
Telephone Number	:	216-282-1582
Fax Number	:	216-927-1801

Provider Business Practice Location Address
First Line	:	3570 WARRENSVILLE CENTER RD STE 106
Second Line	:
City	:	SHAKER HTS
State	:	OH
Zip	:	44122-5226
Country	:	US
Telephone Number	:	216-282-1582
Fax Number	:	216-927-1801

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

Provider Enumeration Date	:	10/21/2021
Last Update Date	:	06/06/2023

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Directions to “ BAILEY SCACCHI RBT” Practice Location

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