Provider Demographics
NPI:1851567929
Name:BARROS-BAILEY, MARY (CRC, NCC, CLCP)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:
Last Name:BARROS-BAILEY
Suffix:
Gender:F
Credentials:CRC, NCC, CLCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7511
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83707-1511
Mailing Address - Country:US
Mailing Address - Phone:208-229-8484
Mailing Address - Fax:
Practice Address - Street 1:6126 W STATE ST
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83703-2741
Practice Address - Country:US
Practice Address - Phone:208-229-8484
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-07
Last Update Date:2019-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation CounselorGroup - Single Specialty