Individual
MR. GOMER RAY BAILEY JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
12201 EUCLID AVE, CLEVELAND, OH 44106-4310
(216) 707-3478
Mailing address
1420 WILLSHIRE RD, LYNDHURST, OH 44124-2448
(216) 702-1225
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6583
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0218310
—
OH
Enumeration date
02/08/2013
Last updated
02/24/2021
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