NPI 1467749085

Kelly Jean Bault

Practitioner Developmental Therapist Carbondale, IL

Practice location

Address: 1800 Old West Main St APT 204, Carbondale, IL 62901-2165
Phone: (815) 343-2776

Registered specialties

Developmental Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 222Q00000X

Other Developmental Therapist providers in Illinois →

Registry record

NPI: 1467749085
Entity type: Individual
Sex (as registered): Female
NPI issued: 3 Jul 2011
Record last updated: 3 Jul 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.