Individual
STASHAUN BAILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPT, CCMA
Contact information
Practice address
2322 SAINT CLAIR DR, TEMPLE HILLS, MD 20748-6845
(202) 455-0323
Mailing address
6801 JEFFERSON STREET NE, STE 150 PMB 3786, ALBUQUERQUE, NM 87109-4390
(202) 455-0323
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
246RM2200X
Medical Laboratory Technician
Primary
F9C8J3D9
MD
246ZC0007X
Surgical Assistant
L2T6A4Z2
MD
Other
Enumeration date
06/13/2022
Last updated
08/21/2024
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