Provider Demographics
NPI:1497034631
Name:KAILING-BAUMGARDNER, JILL MARIE (LBSW)
Entity type:Individual
Prefix:MRS
First Name:JILL
Middle Name:MARIE
Last Name:KAILING-BAUMGARDNER
Suffix:
Gender:F
Credentials:LBSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:745 WATER TOWER RD
Mailing Address - Street 2:
Mailing Address - City:BIG RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49307-2135
Mailing Address - Country:US
Mailing Address - Phone:231-592-1061
Mailing Address - Fax:231-592-5139
Practice Address - Street 1:745 WATER TOWER RD
Practice Address - Street 2:
Practice Address - City:BIG RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49307-2135
Practice Address - Country:US
Practice Address - Phone:231-592-1061
Practice Address - Fax:231-592-5139
Is Sole Proprietor?:No
Enumeration Date:2011-08-05
Last Update Date:2011-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist