Provider Demographics
NPI:1942367602
Name:BAYLIN, JONATHAN FRANCIS (PHD)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:FRANCIS
Last Name:BAYLIN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2403 W 16TH ST
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19806-1308
Mailing Address - Country:US
Mailing Address - Phone:302-655-6529
Mailing Address - Fax:
Practice Address - Street 1:825 N WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19801-1509
Practice Address - Country:US
Practice Address - Phone:302-655-7110
Practice Address - Fax:302-655-6185
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE133103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist