Individual
JESSICA LEE BAILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
6401015890
MI
101YP2500X
Professional Counselor
Primary
6401017384
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1104352244
—
MI
Enumeration date
05/11/2017
Last updated
08/08/2022
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