Individual
PATRICIA BAILEY-JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
24 JOLIET ST, DYER, IN 46311-1705
(244) 631-1170
Mailing address
1040 SIERRA DR STE 400, GREENWOOD, IN 46143-7241
(317) 528-4800
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34007005A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300041505
—
IN
01
—
M47140441
MEDICARE
IN
Enumeration date
12/03/2014
Last updated
03/13/2021
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