Provider Demographics
NPI:1871479733
Name:MIRE, BAILEY (MS PL-SLP-CF-SLP)
Entity type:Individual
Prefix:
First Name:BAILEY
Middle Name:
Last Name:MIRE
Suffix:
Gender:X
Credentials:MS PL-SLP-CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13909 FLORIDA BLVD
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:LA
Mailing Address - Zip Code:70754-6340
Mailing Address - Country:US
Mailing Address - Phone:225-686-4300
Mailing Address - Fax:
Practice Address - Street 1:23300 WALKER SOUTH RD
Practice Address - Street 2:
Practice Address - City:DENHAM SPRINGS
Practice Address - State:LA
Practice Address - Zip Code:70726-8202
Practice Address - Country:US
Practice Address - Phone:225-664-2281
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-14
Last Update Date:2025-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA9273235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist