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Organization
KELLIE D. BAILEY CCC-SLP PC
Active
Organization
KELLIE D. BAILEY CCC-SLP PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KELLIE D. BAILEY CCC-SLP (SPEECH PATHOLOGIST)
(207) 594-5076
Entity
Organization
Contact information
Practice address
3208 CAMDEN RD, WARREN, ME 04864-4124
(207) 594-5076
(207) 594-7339
Mailing address
3208 CAMDEN RD, WARREN, ME 04864-4124
(207) 594-5076
(207) 594-7339
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP655
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
035267
ANTHEM BLUE CROSS BLUE SHIELD
ME
05
—
207850000
—
ME
01
—
7313637
AETNA
ME
Enumeration date
12/14/2009
Last updated
12/14/2009
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