Doctor Name: | ERIC C BAILLY |
NPI Number: | 1871619494 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LPC, CAC III |
License Number: | 4447 |
Business Practice Address: | 700 Broadway Denver, CO - 802033421 |
Business Phone Number: | 3033672900 |
Business Fax Number: | |
Mailing Address: | 2585 Holly St, DENVER |
State: | CO |
Postal Code: | 802073227 |
Phone Number: | 7202256158 |
Fax Number: | |
NPI Enumeration Date: | 03/22/2007 |
NPI Last Update Date: | 01/08/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2084A0401X |
License Number: | 4447 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CO |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Psychiatry & Neurology |
Taxonomy Specialization: | Addiction Medicine |
Taxonomy Definition: | A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine |