Provider Demographics
NPI:1467859173
Name:BAYLOR, OLIVIA LILLIAN
Entity Type:Individual
Prefix:MRS
First Name:OLIVIA
Middle Name:LILLIAN
Last Name:BAYLOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 SHADY NOOK CT
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-3544
Mailing Address - Country:US
Mailing Address - Phone:908-812-4537
Mailing Address - Fax:
Practice Address - Street 1:606 EDMONDSON AVE STE 200
Practice Address - Street 2:
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-3352
Practice Address - Country:US
Practice Address - Phone:410-870-5615
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-24
Last Update Date:2019-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC7219101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health