Provider Demographics
NPI:1902170053
Name:BAILEY, ALCIANIECE T (MA)
Entity Type:Individual
Prefix:
First Name:ALCIANIECE
Middle Name:T
Last Name:BAILEY
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1454 W 94TH PL
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90047-3905
Mailing Address - Country:US
Mailing Address - Phone:310-227-4440
Mailing Address - Fax:
Practice Address - Street 1:1454 W 94TH PL
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90047-3905
Practice Address - Country:US
Practice Address - Phone:310-227-4440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-06
Last Update Date:2012-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor