Provider Demographics
NPI:1235506783
Name:CLAY, BAILEY BRANHAM (MS/CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:BAILEY
Middle Name:BRANHAM
Last Name:CLAY
Suffix:
Gender:F
Credentials:MS/CCC-SLP
Other - Prefix:MS
Other - First Name:BAILEY
Other - Middle Name:BRANHAM
Other - Last Name:REYNOLDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS/CCC-SLP
Mailing Address - Street 1:3100 SHENANDOAH ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77021-1042
Mailing Address - Country:US
Mailing Address - Phone:713-523-3633
Mailing Address - Fax:
Practice Address - Street 1:3100 SHENANDOAH ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77021-1042
Practice Address - Country:US
Practice Address - Phone:713-523-3633
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-31
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVSLP-1588235Z00000X
TX113250235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist