Individual
SHERRY BAILLIES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
371 E 1ST ST, FOND DU LAC, WI 54935-4563
(920) 907-3928
Mailing address
40 CAMELOT DR, FOND DU LAC, WI 54935-8049
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-19-87619
WV
Other
Enumeration date
06/19/2019
Last updated
06/19/2019
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