Individual
BAILEY HLAVACHEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3113 W BELTLINE HWY STE 300, MADISON, WI 53713-2934
(608) 819-6810
(224) 258-1400
Mailing address
3113 W BELTLINE HWY STE 300, MADISON, WI 53713-2934
(608) 819-6810
(224) 258-1400
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-19-98323
WI
Other
Enumeration date
02/11/2020
Last updated
02/11/2020
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