Provider Demographics
NPI:1558994210
Name:BAILEY, WENDY (M ED NCC NCSC)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:
Last Name:BAILEY
Suffix:
Gender:F
Credentials:M ED NCC NCSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:698 BLACKBIRD FOREST RD
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:DE
Mailing Address - Zip Code:19977-9216
Mailing Address - Country:US
Mailing Address - Phone:302-563-2822
Mailing Address - Fax:
Practice Address - Street 1:698 BLACKBIRD FOREST RD
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:DE
Practice Address - Zip Code:19977-9216
Practice Address - Country:US
Practice Address - Phone:302-563-2822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-20
Last Update Date:2020-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator