Provider Demographics
NPI:1962828780
Name:HINZ, BAILEY IRENE (MM, MT-BC)
Entity Type:Individual
Prefix:
First Name:BAILEY
Middle Name:IRENE
Last Name:HINZ
Suffix:
Gender:F
Credentials:MM, MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1150 N BUFFALO DR
Mailing Address - Street 2:UNIT 1091
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-4133
Mailing Address - Country:US
Mailing Address - Phone:630-392-1404
Mailing Address - Fax:
Practice Address - Street 1:1150 N BUFFALO DR
Practice Address - Street 2:UNIT 1091
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-4133
Practice Address - Country:US
Practice Address - Phone:630-392-1404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-17
Last Update Date:2014-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNV20141188375225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist