Individual
BAILY BRENNAN LAVINIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2415 MICHIGAN AVE, SANTA MONICA, CA 90404-4009
(310) 526-4494
Mailing address
12415 NAUTILUS CIR, PALM BEACH GARDENS, FL 33412-2488
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
61245552
WA
Other
Enumeration date
03/07/2017
Last updated
04/03/2025
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