Provider Demographics
NPI:1144569138
Name:BAILEY, LATASHA RENEE' (MS,CCC-SLP)
Entity Type:Individual
Prefix:
First Name:LATASHA
Middle Name:RENEE'
Last Name:BAILEY
Suffix:
Gender:F
Credentials:MS,CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4025 FEATHER LAKES WAY UNIT 5728
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77325-0839
Mailing Address - Country:US
Mailing Address - Phone:713-331-0998
Mailing Address - Fax:
Practice Address - Street 1:9233 WESTHEIMER RD
Practice Address - Street 2:341
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77063-3569
Practice Address - Country:US
Practice Address - Phone:281-841-9307
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX108111235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist