Individual
KAITLYN BAILEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CADACII
Contact information
Practice address
706 GREEN BLVD, AURORA, IN 47001-1506
(812) 727-3504
(812) 727-3504
Mailing address
2070 SALEM RIDGE RD, RISING SUN, IN 47040-9435
(812) 584-8224
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CII-2078
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
611530
—
OH
05
—
CII-2078
—
IN
Enumeration date
12/16/2018
Last updated
12/16/2018
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