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Individual
SUSAN A BAILEY
Active
Individual
SUSAN A BAILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
2459
WV
101YP2500X
Professional Counselor
Primary
2459
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1174164115
—
WV
Enumeration date
10/01/2019
Last updated
06/19/2020
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