Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | ||
Y | 101YM0800X | Mental Health Counselor | ||
N | 101YS0200X | School Counselor | ||
N | 103K00000X | Behavior Analyst |
NPI | 1013368836 |
---|---|
Provider Name | Aniqua Bailey |
First Address | Redford, MI 48240-0629 |
Second Address | Detroit, MI 48219-3132 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2016 |
Last Update Date | 24/06/2021 |