Provider Demographics
NPI:1336949486
Name:HOWARD, BAILEE
Entity type:Individual
Prefix:
First Name:BAILEE
Middle Name:
Last Name:HOWARD
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:413 E CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:AMITE
Mailing Address - State:LA
Mailing Address - Zip Code:70422-2807
Mailing Address - Country:US
Mailing Address - Phone:907-371-4433
Mailing Address - Fax:
Practice Address - Street 1:10510 JOOR RD STE 300A
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70818-3925
Practice Address - Country:US
Practice Address - Phone:225-960-2403
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-18
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician