Individual
BAILEY MALY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1875 STATION PKWY NW, ANDOVER, MN 55304-3319
(763) 639-4757
Mailing address
1875 STATION PKWY NW, ANDOVER, MN 55304-3319
(763) 639-4757
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CC05510
MN
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
07/23/2022
Last updated
03/24/2026
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