Most Relevant Information
Provider Data
| NPI Number: | 1003217894 |
| Provider Name: | IESHAI TAWANDA BAILEY PHD, CMHC, LMHC, CST |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: | MH14483 |
Most Important Dates
| Enumeration Date: | 09/11/2014 |
| Last Updated: | 05/07/2023 |
Provider Practice Location
401 NW 16TH AVENUE N
FORT LAUDERDALE
FL
333116250
Practice Location Phone/Fax
| Phone: | 9047383506 |
| Fax: | 9042043291 |
Provider Mailing Location
114 LAKE EMERALD DR APT 405
OAKLAND PARK
FL
333096250
Provider Mailing Phone/Fax
| Phone: | 7542001463 |
| Fax: | 9042043291 |