Provider Demographics
NPI:1831409903
Name:BAYLIES, BETHANY C
Entity type:Individual
Prefix:MS
First Name:BETHANY
Middle Name:C
Last Name:BAYLIES
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 1:745 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FRYEBURG
Mailing Address - State:ME
Mailing Address - Zip Code:04037-1322
Mailing Address - Country:US
Mailing Address - Phone:207-935-2001
Mailing Address - Fax:
Practice Address - Street 1:745 MAIN ST
Practice Address - Street 2:
Practice Address - City:FRYEBURG
Practice Address - State:ME
Practice Address - Zip Code:04037-1322
Practice Address - Country:US
Practice Address - Phone:207-935-2001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-07
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool