Provider Demographics
NPI:1114668290
Name:BUNN, BAILEE
Entity Type:Individual
Prefix:
First Name:BAILEE
Middle Name:
Last Name:BUNN
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 1:814 JEFFERSON DR
Mailing Address - Street 2:
Mailing Address - City:SANDY SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30350-7112
Mailing Address - Country:US
Mailing Address - Phone:678-603-8561
Mailing Address - Fax:
Practice Address - Street 1:814 JEFFERSON DR
Practice Address - Street 2:
Practice Address - City:SANDY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30350-7112
Practice Address - Country:US
Practice Address - Phone:678-603-8561
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-05
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health