Individual
BAYLEY BRUTUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3149 CONGRESS DR, KOKOMO, IN 46902-8032
(765) 210-9512
Mailing address
3149 CONGRESS DR, KOKOMO, IN 46902-8032
(765) 210-9512
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
07/21/2020
Last updated
07/21/2020
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