Individual
KEVIN BAILLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1111 PRAIRIE PKWY, WEST FARGO, ND 58078-3132
(701) 532-0754
Mailing address
1111 PRAIRIE PKWY, WEST FARGO, ND 58078-3132
(701) 532-0754
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
4560
ND
Other
Enumeration date
02/01/2017
Last updated
02/01/2017
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