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Individual

MRS. TRICIA ANN BAILEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
270 REGENT LN, GOREVILLE, IL 62939-1913
(618) 995-9817
Mailing address
270 REGENT LN, GOREVILLE, IL 62939-1913
(618) 995-9817

Taxonomy

Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
IL

Other

Enumeration date
10/16/2010
Last updated
10/16/2010
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