Provider Demographics
NPI:1972958783
Name:FREGEAU, BAILEY R
Entity Type:Individual
Prefix:MS
First Name:BAILEY
Middle Name:R
Last Name:FREGEAU
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 1:9 W COURT ST
Mailing Address - Street 2:
Mailing Address - City:PLATTSBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12901-2301
Mailing Address - Country:US
Mailing Address - Phone:518-534-1842
Mailing Address - Fax:518-561-3805
Practice Address - Street 1:49 BROAD ST
Practice Address - Street 2:
Practice Address - City:PLATTSBURGH
Practice Address - State:NY
Practice Address - Zip Code:12901-3396
Practice Address - Country:US
Practice Address - Phone:518-957-6000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-29
Last Update Date:2021-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist