Provider Demographics
NPI:1174113278
Name:STALLARD, BAYLEE ADISON (RBT)
Entity type:Individual
Prefix:MRS
First Name:BAYLEE
Middle Name:ADISON
Last Name:STALLARD
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:MRS
Other - First Name:BAYLEE
Other - Middle Name:ADISON
Other - Last Name:LOCKHART
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RBT
Mailing Address - Street 1:4015 W DUBLIN GRANVILLE RD
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-1436
Mailing Address - Country:US
Mailing Address - Phone:614-451-4465
Mailing Address - Fax:
Practice Address - Street 1:4015 W DUBLIN GRANVILLE RD
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43017-1436
Practice Address - Country:US
Practice Address - Phone:614-451-4465
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-22
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician