MEDICARE: BAILEY DONALEE SMITH BCBA, LBA-OK

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	103K00000X	Behavior Analyst	1-25-83159	OK

General Provider Information

NPI Number	:	1629914395
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BAILEY DONALEE SMITH BCBA, LBA-OK

Provider Business Mailing Address
First Line	:	301 N CHERRY AVE
Second Line	:
City	:	UNION CITY
State	:	OK
Zip	:	73090-9614
Country	:	US
Telephone Number	:	405-779-3996
Fax Number	:

Provider Business Practice Location Address
First Line	:	301 N CHERRY AVE
Second Line	:
City	:	UNION CITY
State	:	OK
Zip	:	73090-9614
Country	:	US
Telephone Number	:	405-779-3996
Fax Number	:

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

Provider Enumeration Date	:	04/27/2026
Last Update Date	:	04/27/2026

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