Individual
BAILIE YOUNGSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
756 WINFREE AVE, LAKELAND, FL 33801-5556
(443) 863-9678
Mailing address
756 WINFREE AVE, LAKELAND, FL 33801-5556
(443) 863-9678
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
17399
FL
Other
Enumeration date
04/20/2021
Last updated
04/20/2021
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