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Contact Information

GOMER R BAILEY JR, PHD
12201 EUCLID AVE
CLEVELAND, OH44106-4310
 Phone: 216-707-3478
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

103TC0700X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for GOMER R BAILEY JR · (Male)

NPI # 1740529817
Status Active
Credentials PHD
Entity Individual
Enumeration date 02/08/2013
Last updated 02/24/2021 - About 5 years ago
Sole proprietor 1 Yes
Identifiers
  • OH License # 6583
  • OH Medicaid 0218310
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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