Individual
DEANNA BAILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NCAC II, SAP, CAC-AD
Contact information
Practice address
370 VIRGINIA AVE, HAGERSTOWN, MD 21740-6267
(301) 766-0065
Mailing address
370 VIRGINIA AVE, HAGERSTOWN, MD 21740-6267
(301) 766-0065
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
324505500
—
MD
Enumeration date
10/09/2015
Last updated
10/09/2015
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