Individual
MARY ELLEN BAILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
8007 LADY LEWIS CT, TELEHEALTH, SPRINGFIELD, VA 22153-2702
(703) 539-2183
Mailing address
8007 LADY LEWIS CT, SPRINGFIELD, VA 22153-2702
(703) 539-2183
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
0904009491
VA
Other
Enumeration date
06/10/2016
Last updated
08/31/2021
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