Individual
BAILEY TERRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
408 N 1ST ST, GLENWOOD, AR 71943-9250
(870) 356-7404
Mailing address
201 REGENCY PKWY, MANSFIELD, TX 76063-5638
(682) 400-0305
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
RBT-19-101561
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RBT-19-101561
RBT LICENSE
—
Enumeration date
10/16/2019
Last updated
12/11/2024
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