Basic Information
| Provider Information | |||||||||
| NPI: | 1073772869 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BAILEY | ||||||||
| FirstName: | KATHLEEN | ||||||||
| MiddleName: | PARKER | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.A., CPC-I | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3435 W CRAIG RD SUITE A | ||||||||
| Address2: | ALLIANCE FAMILY SERVICES | ||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 890325115 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7027500377 | ||||||||
| FaxNumber: | 7025387928 | ||||||||
| Practice Location | |||||||||
| Address1: | 3435 W CRAIG RD | ||||||||
| Address2: | SUITE A | ||||||||
| City: | NORTH LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 890325115 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7027500377 | ||||||||
| FaxNumber: | 7025387928 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/05/2008 | ||||||||
| LastUpdateDate: | 09/20/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | CI0043 | NV | Y | Behavioral Health & Social Service Providers | Counselor | Professional | 390200000X | RC00060241 | WA | N | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.