Provider Demographics
NPI:1326766494
Name:BAILEY, SAVANAH
Entity Type:Individual
Prefix:
First Name:SAVANAH
Middle Name:
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 1:20 MARTIN DRIVE
Mailing Address - Street 2:HOUSE 10
Mailing Address - City:ONA
Mailing Address - State:WV
Mailing Address - Zip Code:25545
Mailing Address - Country:US
Mailing Address - Phone:330-843-3523
Mailing Address - Fax:
Practice Address - Street 1:120 HANWORTH LN
Practice Address - Street 2:
Practice Address - City:DANIELS
Practice Address - State:WV
Practice Address - Zip Code:25832-9029
Practice Address - Country:US
Practice Address - Phone:304-542-3544
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-16
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist