NPI 1245241769 · live from the CMS NPI Registry
Laura L. Bailet, PHD
Psychologist, Clinical Child & Adolescent in Jacksonville, FL. National Provider Identifier 1245241769, active.
NPI record
| NPI | 1245241769 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Psychologist, Clinical Child & Adolescent 103TC2200X |
| Practice location | 807 Childrens Way, Jacksonville, FL 32207 |
| Practice phone | 904-390-3780 |
| Mailing address | Po Box 191, Provider Enrollment Dept, Rockland, DE 19732 |
| Enumerated | August 10, 2006 |
| Last updated | September 3, 2011 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychologist, Clinical Child & Adolescent primary | 103TC2200X | SS0000519 (FL) |
| Psychologist, School | 103TS0200X | SS0000519 (FL) |
| Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology | 2084N0402X | SS0000519 (FL) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.