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Individual
THEODORE BAILEY
Active
Individual
THEODORE BAILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMSW-CLINICAL
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6801086864
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6801086864
MICHIGAN BOARD OF SOCIAL WORK
MI
Enumeration date
08/19/2015
Last updated
08/19/2015
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