Individual
KIMBERLY BAILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
914 E BROADWAY, 1ST FLOOR, LOUISVILLE, KY 40204-1037
(502) 589-8600
(502) 589-8771
Mailing address
101 W MUHAMMAD ALI BLVD, LOUISVILLE, KY 40202-1423
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3673
KY
106H00000X
Marriage & Family Therapist
0802
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100284120
—
KY
05
—
7100288950
—
KY
Enumeration date
07/17/2009
Last updated
07/11/2014
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