Individual
CHARLES E BAILEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
953 THOMAS CIR, PORTSMOUTH, VA 23704-4171
(323) 204-6084
Mailing address
953 THOMAS CIR, PORTSMOUTH, VA 23704-4171
(323) 204-6084
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
06/17/2021
Last updated
06/17/2021
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