| Lou Ann Baylock,llc | |
|
193 Main St Middletown CT 06457-3423 | |
| (860) 343-0321 | |
| (860) 343-0321 |
| Full Name | Lou Ann Baylock,llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 193 Main St, Middletown, Connecticut |
| Authorized Official Name and Position | Louise Ann Baylock (OWNER/THERAPIST) |
| Authorized Official Contact | 8603430321 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lou Ann Baylock,llc 193 Main St Middletown CT 06457-3423 Ph: (860) 343-0321 | Lou Ann Baylock,llc 193 Main St Middletown CT 06457-3423 Ph: (860) 343-0321 |
| NPI Number | 1255527602 |
|---|---|
| Provider Enumeration Date | 09/19/2007 |
| Last Update Date | 10/07/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255527602 | NPI | - | NPPES |
| 004246668-00 | Medicaid | CT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 005189 (Connecticut) | Primary |
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