Provider Demographics
NPI:1073128757
Name:SELIG, BAILA (MA, SLP-CF)
Entity Type:Individual
Prefix:
First Name:BAILA
Middle Name:
Last Name:SELIG
Suffix:
Gender:F
Credentials:MA, SLP-CF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1225 OCEAN PKWY APT 5D
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-5122
Mailing Address - Country:US
Mailing Address - Phone:845-304-6261
Mailing Address - Fax:
Practice Address - Street 1:1225 OCEAN PKWY APT 5D
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-5122
Practice Address - Country:US
Practice Address - Phone:845-304-6261
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-10
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist