Provider Demographics
NPI:1497421234
Name:COATOAM, BAILEY ELIZABETH
Entity Type:Individual
Prefix:
First Name:BAILEY
Middle Name:ELIZABETH
Last Name:COATOAM
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 1:32216 COUNTRY CLUB DR
Mailing Address - Street 2:
Mailing Address - City:AVON LAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44012-2720
Mailing Address - Country:US
Mailing Address - Phone:440-654-1939
Mailing Address - Fax:
Practice Address - Street 1:3433 AGLER RD STE 2020
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43219-3387
Practice Address - Country:US
Practice Address - Phone:614-600-2706
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-20
Last Update Date:2021-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator