Individual
BAILEY DELONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
3515 E FLETCHER AVE, TAMPA, FL 33613-4706
(813) 821-8038
(813) 974-4325
Mailing address
PO BOX 917770, ORLANDO, FL 32891-0001
(813) 821-8038
(813) 974-4325
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Q1-0011969
DE
1041C0700X
Clinical Social Worker
Primary
SW19922
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
115367100
—
FL
Enumeration date
01/11/2022
Last updated
11/02/2022
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