Individual
GERRY LEE BAILEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CG 60801682
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
60801682
WA
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
04/18/2019
Last updated
01/20/2020
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