NPI 1720537475 · live from the CMS NPI Registry
Kyle Shane Bailey, BA
Counselor in Spokane, WA. National Provider Identifier 1720537475, active.
NPI record
| NPI | 1720537475 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Counselor 101Y00000X |
| Practice location | 5901 N Lidgerwood St Ste 115, Spokane, WA 99208 |
| Practice phone | 509-838-4651 |
| Mailing address | 107 S Division St, Spokane, WA 99202 |
| Enumerated | September 22, 2016 |
| Last updated | November 19, 2018 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Behavior Analyst | 103K00000X | — |
| Counselor primary | 101Y00000X | CG60713626 (WA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.