Provider Demographics
NPI:1952682023
Name:BAILEY, EMILY C (MM, MT-BC, NMT)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:C
Last Name:BAILEY
Suffix:
Gender:F
Credentials:MM, MT-BC, NMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1934 S 600 E
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84105-3037
Mailing Address - Country:US
Mailing Address - Phone:970-988-1631
Mailing Address - Fax:
Practice Address - Street 1:1934 S 600 E
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84105-3037
Practice Address - Country:US
Practice Address - Phone:970-988-1631
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-02
Last Update Date:2011-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO08515225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist