Individual
BAILEY KOEBERNICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8856 BRINDISI PARK AVE, LAS VEGAS, NV 89148-5901
(847) 975-8712
Mailing address
8856 BRINDISI PARK AVE, LAS VEGAS, NV 89148-5901
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
140529
AK
235Z00000X
Speech-Language Pathologist
SLP12179
AZ
235Z00000X
Speech-Language Pathologist
Primary
SP-2673
NV
Other
Enumeration date
05/04/2020
Last updated
05/04/2020
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