Provider Demographics
NPI:1013754662
Name:BAILEY, JAYLAH
Entity type:Individual
Prefix:
First Name:JAYLAH
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 1:3430 BURNET AVENUE
Mailing Address - Street 2:4007
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-2833
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3430 BURNET AVENUE
Practice Address - Street 2:4007
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-2833
Practice Address - Country:US
Practice Address - Phone:502-889-9728
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-11
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT021152225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist