Individual
EDWINA BAILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RADT
Contact information
Practice address
1693 NADOWA STREET, SOUTH LAKE TAHOE, CA 96150
(623) 889-4711
Mailing address
PO BOX 770, HAPPY CAMP, CA 96039-0770
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LAAC-15597
AZ
171M00000X
Case Manager/Care Coordinator
—
—
174H00000X
Health Educator
—
—
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
09/20/2024
Last updated
12/06/2025
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