KELLY JEAN BAULT

CARBONDALE, IL
NPI1467749085
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy222Q00000X Developmental Therapist
Enumeration Date2011-07-03
Last Update Date2011-07-03
Business Address
-- KELLY JEAN BAULT
1800 OLD WEST MAIN ST APT 204
CARBONDALE, IL 62901-2165
Phone number: 815-343-2776
Mailing Address
-- KELLY JEAN BAULT
1800 OLD WEST MAIN ST APT 204
CARBONDALE, IL 62901-2165
Phone number: 815-343-2776