Provider Demographics
NPI:1881450435
Name:BAIL, ANGEL RAE
Entity type:Individual
Prefix:
First Name:ANGEL
Middle Name:RAE
Last Name:BAIL
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 1:606 S GORHAM ST
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49203-2027
Mailing Address - Country:US
Mailing Address - Phone:517-787-9887
Mailing Address - Fax:517-787-1906
Practice Address - Street 1:2245 W PARNALL RD
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49201-9000
Practice Address - Country:US
Practice Address - Phone:517-787-9887
Practice Address - Fax:517-787-1906
Is Sole Proprietor?:No
Enumeration Date:2024-02-22
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker