Provider Demographics
NPI:1467824557
Name:BAILEY, BREANNA JUNE (MA, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:BREANNA
Middle Name:JUNE
Last Name:BAILEY
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:BREANNA
Other - Middle Name:JUNE
Other - Last Name:EARNEST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, CCC-SLP
Mailing Address - Street 1:1111 CORNWALL AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-5039
Mailing Address - Country:US
Mailing Address - Phone:360-734-5121
Mailing Address - Fax:
Practice Address - Street 1:1201 CORNWALL AVE STE 201
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-5051
Practice Address - Country:US
Practice Address - Phone:360-734-5121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-28
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist