Individual
BAILEY SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1609 N DIXIE AVE STE 114, ELIZABETHTOWN, KY 42701-7494
(270) 702-4641
(615) 577-5654
Mailing address
PO BOX 931142, ATLANTA, GA 31193-1142
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-24-321411
IN
Other
Enumeration date
03/02/2020
Last updated
02/08/2024
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