Provider Demographics
NPI:1073241725
Name:KAUFMANN, BAILEY ROSE
Entity Type:Individual
Prefix:
First Name:BAILEY
Middle Name:ROSE
Last Name:KAUFMANN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4151 W MICHELLE DR
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-2517
Mailing Address - Country:US
Mailing Address - Phone:602-538-0792
Mailing Address - Fax:
Practice Address - Street 1:251 W MOHAWK LN
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85027-5946
Practice Address - Country:US
Practice Address - Phone:623-445-3700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-10
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLPA138202355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant