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NPI Code Detail

MEDICARE: AUBREY CRISTEN BAILEY

MEDICARE: AUBREY CRISTEN 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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1750923421
Entity Type Code : Individual
Provider Name (Legal Business Name) : AUBREY CRISTEN BAILEY
Provider Business Mailing Address
First Line : 344 FAYETTEVILLE AVE
Second Line :
City : ALMA
State : AR
Zip : 72921-3655
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 344 FAYETTEVILLE AVE
Second Line :
City : ALMA
State : AR
Zip : 72921-3655
Country : US
Telephone Number : 479-430-7603
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/14/2019
Last Update Date : 10/14/2019

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Directions to “ AUBREY CRISTEN BAILEY ” Practice Location

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