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Individual

MR. MICKEY RONALD BAILEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MS

Contact information

Practice address
2200 FORT ROOTS DR, 116, NORTH LITTLE ROCK, AR 72114-1709
(501) 257-4115
(501) 257-4116
Mailing address
1604 NORTHLINE DR, NORTH LITTLE ROCK, AR 72116-6376
(501) 257-4115
(501) 257-4116

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
101Y00000X
COUNSELOR
AR
Enumeration date
08/13/2006
Last updated
07/08/2007
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