Provider Demographics
NPI:1982676425
Name:BAILEY, ANNIKA
Entity Type:Individual
Prefix:
First Name:ANNIKA
Middle Name:
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 1:45850 POMEROY PIKE
Mailing Address - Street 2:
Mailing Address - City:RACINE
Mailing Address - State:OH
Mailing Address - Zip Code:45771-9545
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1 CONVOCATION CENTER
Practice Address - Street 2:OHIO UNIVERSITY
Practice Address - City:ATHENS
Practice Address - State:OH
Practice Address - Zip Code:45701-2979
Practice Address - Country:US
Practice Address - Phone:740-593-1206
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2014-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAT 0025562255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer