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Individual
ERIC C BAILLY
Active
Individual
ERIC C BAILLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC, CAC III
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2284
CO
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
4447
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AB30627
EMPLOYEE ID
CO
Enumeration date
03/22/2007
Last updated
01/08/2008
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