Individual
BAYLEIGH DURHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
343 FOUNTAINS PKWY STE 201, FAIRVIEW HEIGHTS, IL 62208-2170
(618) 515-1441
Mailing address
343 FOUNTAINS PKWY STE 201, FAIRVIEW HEIGHTS, IL 62208-2170
(618) 515-1441
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-21-168290
IL
Other
Enumeration date
05/26/2021
Last updated
05/26/2021
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