Individual
DR. STEFAN A. BAILIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
1600 UNIVERSITY AVE W, SUITE 203, SAINT PAUL, MN 55104-3898
(651) 645-0980
Mailing address
1910 E 86TH ST, APT. 336, BLOOMINGTON, MN 55425-2125
(651) 283-6667
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP5333
MN
103TB0200X
Cognitive & Behavioral Psychologist
LP5333
MN
103TC0700X
Clinical Psychologist
LP5333
MN
103TC1900X
Counseling Psychologist
LP5333
MN
103TC2200X
Clinical Child & Adolescent Psychologist
LP5333
MN
103TF0000X
Family Psychologist
LP5333
MN
103TH0100X
Health Service Psychologist
LP5333
MN
103TP2701X
Group Psychotherapy Psychologist
LP5333
MN
Other
Enumeration date
04/21/2011
Last updated
04/14/2020
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