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General NPI Number Information
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NPI Number | 1114323888
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Entity Type | Individual
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Provider Name | CHERYL BAYLIS M.A., ITDS
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Gender | Female
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Dates
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Enumeration Date | 11/07/2014
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Last Update Date | 07/20/2018
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Provider Practice Location Address
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Address Line | 37328 N COUNTY ROAD 44A
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City | EUSTIS
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State | FL
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Zip | 32736
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Country | US
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Telephone | 352-267-1101
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Fax |
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Provider Business Mailing Address
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Address Line | 37328 N COUNTY ROAD 44A
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City | EUSTIS
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State | FL
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Zip | 32736-9753
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Country | US
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Telephone | 352-267-1101
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State | FL
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