Provider Demographics
NPI:1164920948
Name:BAILEY, PAIGE ELIZABETH
Entity Type:Individual
Prefix:
First Name:PAIGE
Middle Name:ELIZABETH
Last Name:BAILEY
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 1:3785 WOODLAND DR
Mailing Address - Street 2:
Mailing Address - City:METAMORA
Mailing Address - State:MI
Mailing Address - Zip Code:48455-9627
Mailing Address - Country:US
Mailing Address - Phone:810-358-4868
Mailing Address - Fax:
Practice Address - Street 1:3785 WOODLAND DR
Practice Address - Street 2:
Practice Address - City:METAMORA
Practice Address - State:MI
Practice Address - Zip Code:48455-9627
Practice Address - Country:US
Practice Address - Phone:810-358-4868
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-26
Last Update Date:2018-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst