Individual
AMY BAILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CDCA
Contact information
Practice address
6150 PARK SQUARE DR STE B, LORAIN, OH 44053-4153
(440) 984-3882
Mailing address
1925 HAYES AVE, SANDUSKY, OH 44870-4737
(419) 557-5177
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDCA.166116
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CDCA.166116
OHIO CHEMICAL DEPENDENCY PROFESSIONALS BOARD
OH
Enumeration date
06/26/2018
Last updated
08/08/2019
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