Provider Demographics
NPI:1497464416
Name:DELGADO, BAILEY REBECCA (RBT)
Entity Type:Individual
Prefix:MRS
First Name:BAILEY
Middle Name:REBECCA
Last Name:DELGADO
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5318 EVA ST
Mailing Address - Street 2:
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29418-5806
Mailing Address - Country:US
Mailing Address - Phone:843-834-9590
Mailing Address - Fax:
Practice Address - Street 1:828 WAPPOO RD
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-5865
Practice Address - Country:US
Practice Address - Phone:847-084-3297
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-17
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician