Individual
MISS BELINDA JAYNE BAXLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
830 MILL ST, PARAGOULD, AR 72450-2398
(334) 435-0196
Mailing address
4101 ANGELUS ST, PARAGOULD, AR 72450-2523
(870) 450-3456
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
193534783
—
AR
Enumeration date
11/01/2012
Last updated
10/26/2020
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