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MRS. COLETTE RAE BAILEY

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
1020 S MAIN ST, SUITE 100, SALT LAKE CITY, UT 84101-3176
(801) 539-7000
Mailing address
1758 E 11400 S, SANDY, UT 84092-5430
(801) 571-8837

Taxonomy

Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
5644173-3102
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
U002
887450
UT
01
U006
107035987101
UT
Enumeration date
01/14/2006
Last updated
07/08/2007
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