Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | PSY1000607 | DC |
NPI | 1053634014 |
---|---|
Provider Name | Lisa D Bailey |
First Address | Washington, DC 20010-2916 |
Second Address | Washington, DC 20010-2916 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/03/2010 |
Last Update Date | 07/06/2016 |