Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst |
NPI | 1134651490 |
---|---|
Provider Name | Melissa Bailey |
First Address | Lanham, MD 20706-1868 |
Second Address | Lanham, MD 20706-1868 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2017 |
Last Update Date | 28/03/2017 |