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Individual

BAILEA SCOTT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MCD, SLP

Contact information

Practice address
5437 EISENHAUER RD, SAN ANTONIO, TX 78218-3703
(210) 646-9576
Mailing address
5437 EISENHAUER RD, SAN ANTONIO, TX 78218-3703

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
114098
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
114098
TEXAS DEPARTMENT OF LICENCING AND REGULATION- SLP LICENSE
TX
Enumeration date
08/24/2018
Last updated
08/24/2018
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