| Doctor Name: | SUSAN BREEN BAILEY |
| NPI Number: | 1083998306 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | P.L.P.C. |
| License Number: | 2010036840 |
| Business Practice Address: | 115 Brierton Ln Festus, MO - 630281972 |
| Business Phone Number: | 6369310300 |
| Business Fax Number: | 6369333510 |
| Mailing Address: | 115 Brierton Ln, FESTUS |
| State: | MO |
| Postal Code: | 630281972 |
| Phone Number: | 6369310300 |
| Fax Number: | 6369333510 |
| NPI Enumeration Date: | 10/05/2011 |
| NPI Last Update Date: | 10/05/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 2010036840 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |