Provider Demographics
NPI:1942711411
Name:BAILEY, MARINA ANN
Entity Type:Individual
Prefix:
First Name:MARINA
Middle Name:ANN
Last Name:BAILEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2296 GLENMORE TER
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-3051
Mailing Address - Country:US
Mailing Address - Phone:301-279-8858
Mailing Address - Fax:
Practice Address - Street 1:2296 GLENMORE TER
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-3051
Practice Address - Country:US
Practice Address - Phone:301-279-8858
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-23
Last Update Date:2017-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician