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Individual

TRACEY ETHAN BAILEY

Active
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Individual

TRACEY ETHAN BAILEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CMT, EP-C, CES, CPT

Taxonomy

Speciality
Code
Description
License number
State
173C00000X
Reflexologist
71264
CA
174H00000X
Health Educator
20203
2255R0406X
Blind Rehabilitation Specialist/Technologist
20203
CA
225700000X
Massage Therapist
Primary
71264
CA
226300000X
Kinesiotherapist
20203
246Z00000X
Other Specialist/Technologist
CA
3747P1801X
Personal Care Attendant
CA

Other

Enumeration date
02/06/2019
Last updated
02/07/2019
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