Provider Demographics
NPI:1558600254
Name:ROWAN-BAILEY, STEPHANIE TAYSHIA (MA, ACMHCE)
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:TAYSHIA
Last Name:ROWAN-BAILEY
Suffix:
Gender:F
Credentials:MA, ACMHCE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:782 E PIONEER RD # 100
Mailing Address - Street 2:
Mailing Address - City:DRAPER
Mailing Address - State:UT
Mailing Address - Zip Code:84020-5734
Mailing Address - Country:US
Mailing Address - Phone:801-810-7722
Mailing Address - Fax:
Practice Address - Street 1:782 E PIONEER RD # 100
Practice Address - Street 2:
Practice Address - City:DRAPER
Practice Address - State:UT
Practice Address - Zip Code:84020-5734
Practice Address - Country:US
Practice Address - Phone:801-810-7722
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-01
Last Update Date:2013-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7830423-6010101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health