Individual
MRS. HEIDI BAILEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3975 KENNETH DR., ROOTSTOWN, OH 44272
(330) 850-5141
(330) 850-5349
Mailing address
3975 KENNETH DR., ROOTSTOWN, OH 44272
(330) 850-5141
(330) 850-5349
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1063909612
—
OH
Enumeration date
05/21/2021
Last updated
06/01/2021
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