Individual
BAILEY BAGWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
24 WHITLOCK SQ SW, MARIETTA, GA 30064-3260
(678) 301-0071
Mailing address
24 WHITLOCK SQ SW, MARIETTA, GA 30064-3260
(678) 301-0071
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
23-2157-435199
GA
Other
Enumeration date
07/25/2023
Last updated
07/25/2023
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