Provider Demographics
NPI:1558895326
Name:BAILEY, DOTTIE-JEAN
Entity type:Individual
Prefix:
First Name:DOTTIE-JEAN
Middle Name:
Last Name:BAILEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:373 UPPER TURNPIKE RD
Mailing Address - Street 2:
Mailing Address - City:WHITEHALL
Mailing Address - State:NY
Mailing Address - Zip Code:12887-1911
Mailing Address - Country:US
Mailing Address - Phone:518-350-7123
Mailing Address - Fax:
Practice Address - Street 1:14 W NOTRE DAME ST
Practice Address - Street 2:
Practice Address - City:GLENS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12801-2817
Practice Address - Country:US
Practice Address - Phone:518-350-7123
Practice Address - Fax:518-350-7123
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-18
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0908191041C0700X
1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical