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Individual

MRS. DIANE P. BAILEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
2021 S. WAVERLY, SUITE 700, SPRINGFIELD, MO 65804
(414) 569-2398
Mailing address
3830 S. QUEENS CT., SPRINGFIELD, MO 65804
(417) 569-2398

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
000884
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
498589902
MO
Enumeration date
03/26/2007
Last updated
12/04/2008
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