Organization
JILL N BAILLIO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JILL N BAILLIO PH.D. (OWNER)
(813) 294-0577
Entity
Organization
Contact information
Practice address
205 S 5TH AVE, UNIT 3, WILMINGTON, NC 28401-4549
(813) 294-0577
(910) 794-4531
Mailing address
PO BOX 16310, WILMINGTON, NC 28408-6310
(813) 294-0577
(910) 794-4531
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Enumeration date
12/17/2010
Last updated
12/17/2010
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