Provider Demographics
NPI:1295148666
Name:BAILEY, BETHANY (CCC-SLP)
Entity type:Individual
Prefix:
First Name:BETHANY
Middle Name:
Last Name:BAILEY
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:BETHANY
Other - Middle Name:LYNN
Other - Last Name:FRANKLIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:613 S LAWRENCE ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-2208
Mailing Address - Country:US
Mailing Address - Phone:303-956-6007
Mailing Address - Fax:
Practice Address - Street 1:3625 E B ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98404-1524
Practice Address - Country:US
Practice Address - Phone:253-475-2507
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-03
Last Update Date:2015-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist