Provider Demographics
NPI:1548755465
Name:BAILLARGEON, JILLIAN FAY
Entity Type:Individual
Prefix:
First Name:JILLIAN
Middle Name:FAY
Last Name:BAILLARGEON
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 1:78 ANDERSON DR
Mailing Address - Street 2:
Mailing Address - City:METHUEN
Mailing Address - State:MA
Mailing Address - Zip Code:01844-7410
Mailing Address - Country:US
Mailing Address - Phone:978-835-5758
Mailing Address - Fax:
Practice Address - Street 1:78 ANDERSON DR
Practice Address - Street 2:
Practice Address - City:METHUEN
Practice Address - State:MA
Practice Address - Zip Code:01844-7410
Practice Address - Country:US
Practice Address - Phone:978-835-5758
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-22
Last Update Date:2018-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health