Provider Demographics
NPI:1760954028
Name:SPENSKI, BAILEY (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:BAILEY
Middle Name:
Last Name:SPENSKI
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 1:1201 PRESERVATION WAY UNIT 301
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28405-4345
Mailing Address - Country:US
Mailing Address - Phone:336-847-2679
Mailing Address - Fax:
Practice Address - Street 1:75 CAVALIER DR
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28405-4444
Practice Address - Country:US
Practice Address - Phone:910-239-9500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-27
Last Update Date:2018-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12873235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist