Provider Demographics
NPI:1790450807
Name:BAILLY-SIMAO, JULIANA MARGUERITE (BCBA, LBA)
Entity Type:Individual
Prefix:MS
First Name:JULIANA
Middle Name:MARGUERITE
Last Name:BAILLY-SIMAO
Suffix:
Gender:F
Credentials:BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 KNOLLWOOD RD
Mailing Address - Street 2:
Mailing Address - City:ROCKY HILL
Mailing Address - State:CT
Mailing Address - Zip Code:06067-1123
Mailing Address - Country:US
Mailing Address - Phone:860-838-1529
Mailing Address - Fax:
Practice Address - Street 1:61 COMMERCIAL BLVD
Practice Address - Street 2:
Practice Address - City:TORRINGTON
Practice Address - State:CT
Practice Address - Zip Code:06790-7224
Practice Address - Country:US
Practice Address - Phone:860-482-0737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-11
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1250103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst