Provider Demographics
NPI:1659631711
Name:BAILEY, NATASHA LEIGH (PHD, BCBA, LBA)
Entity type:Individual
Prefix:MS
First Name:NATASHA
Middle Name:LEIGH
Last Name:BAILEY
Suffix:
Gender:F
Credentials:PHD, BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:374A KALUA RD
Mailing Address - Street 2:
Mailing Address - City:WAILUKU
Mailing Address - State:HI
Mailing Address - Zip Code:96793-2136
Mailing Address - Country:US
Mailing Address - Phone:808-437-1923
Mailing Address - Fax:
Practice Address - Street 1:374A KALUA RD
Practice Address - Street 2:
Practice Address - City:WAILUKU
Practice Address - State:HI
Practice Address - Zip Code:96793-2136
Practice Address - Country:US
Practice Address - Phone:808-437-1923
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-23
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1-09-5257103K00000X
MO2012010604103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty