Provider Demographics
NPI:1144982380
Name:BAILEY, AYAKO C
Entity type:Individual
Prefix:
First Name:AYAKO
Middle Name:C
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 1:1715 S JACKSON AVE.
Mailing Address - Street 2:APT 22H
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74107-2677
Mailing Address - Country:US
Mailing Address - Phone:601-334-1800
Mailing Address - Fax:
Practice Address - Street 1:2488 E 81ST ST STE 485
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74137-4265
Practice Address - Country:US
Practice Address - Phone:918-932-1117
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-05
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator