Provider Demographics
NPI:1750845434
Name:BAILEY, LINDA ANNE (DT-V/DT-O&M)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:ANNE
Last Name:BAILEY
Suffix:
Gender:F
Credentials:DT-V/DT-O&M
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1514 LINDEN AVE
Mailing Address - Street 2:
Mailing Address - City:JANESVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53548-2831
Mailing Address - Country:US
Mailing Address - Phone:608-403-7255
Mailing Address - Fax:
Practice Address - Street 1:1514 LINDEN AVE
Practice Address - Street 2:
Practice Address - City:JANESVILLE
Practice Address - State:WI
Practice Address - Zip Code:53548-2831
Practice Address - Country:US
Practice Address - Phone:608-403-7255
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-26
Last Update Date:2019-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist