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Individual

BAILEY IANNOLO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3960 IVYWOOD LN, PUEBLO, CO 81005-2567
(719) 565-1276
Mailing address
3960 IVYWOOD LN, PUEBLO, CO 81005-2567

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-20-44999
103K00000X
Behavior Analyst

Other

Enumeration date
01/05/2021
Last updated
10/14/2021
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