Organization
THE BAULCH CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEANA S. BAULCH EDD (OWNER)
(662) 213-5815
Entity
Organization
Contact information
Practice address
7095 WILL ROBBINS HWY, NETTLETON, MS 38858-6062
(662) 213-5815
Mailing address
425 HIGHWAY 6, NETTLETON, MS 38858-9561
(662) 213-5815
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
106E00000X
Assistant Behavior Analyst
—
—
2251P0200X
Pediatric Physical Therapist
—
—
225XP0200X
Pediatric Occupational Therapist
—
—
Other
Enumeration date
09/23/2021
Last updated
09/23/2021
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