Provider Demographics
NPI:1518161900
Name:BAILEY, ROSCHELLE E (CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:ROSCHELLE
Middle Name:E
Last Name:BAILEY
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4216 PLANTERS WATCH DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28278-0040
Mailing Address - Country:US
Mailing Address - Phone:704-299-5569
Mailing Address - Fax:
Practice Address - Street 1:5700 EXECUTIVE CENTER DR
Practice Address - Street 2:SUITE110
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28212-8858
Practice Address - Country:US
Practice Address - Phone:704-566-6040
Practice Address - Fax:704-525-9337
Is Sole Proprietor?:No
Enumeration Date:2007-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7067235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist