Provider Demographics
NPI:1720586548
Name:AGUINAGA, BAILEY NICOLE
Entity Type:Individual
Prefix:MRS
First Name:BAILEY
Middle Name:NICOLE
Last Name:AGUINAGA
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:BAILEY
Other - Middle Name:NICOLE
Other - Last Name:DENNY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:901 N WASHINGTON ST STE 501
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22314-1535
Mailing Address - Country:US
Mailing Address - Phone:571-257-8807
Mailing Address - Fax:
Practice Address - Street 1:901 N WASHINGTON ST STE 501
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-1535
Practice Address - Country:US
Practice Address - Phone:571-257-8807
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-26
Last Update Date:2018-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2204000002235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty