Provider Demographics
NPI:1073952958
Name:BAILIE, JILLIAN
Entity Type:Individual
Prefix:DR
First Name:JILLIAN
Middle Name:
Last Name:BAILIE
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:JILLIAN
Other - Middle Name:
Other - Last Name:SCHNEIDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:601 INDEPENDENCE RD
Mailing Address - Street 2:
Mailing Address - City:HURLBURT FIELD
Mailing Address - State:FL
Mailing Address - Zip Code:32544-5601
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:601 INDEPENDENCE RD
Practice Address - Street 2:
Practice Address - City:HURLBURT FIELD
Practice Address - State:FL
Practice Address - Zip Code:32544-5601
Practice Address - Country:US
Practice Address - Phone:850-881-2505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-24
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist