| Organization Name: | BAILLIO PSYCHOLOGICAL SERVICES, PA |
| NPI Number: | 1053798702 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JILL N BAILLIO (OWNER) |
| Mailing Address: | 735 Arlington Ave N Suite 205 Saint Petersburg |
| State: | FL US |
| Postal Code: | 337013652 |
| Phone Number: | 8132940577 |
| Fax Number: | |
| NPI Enumeration Date: | 05/01/2015 |
| NPI Last Update Date: | 03/08/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC1900X |
| License Number: | PY8287 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Counseling |
| Taxonomy Definition: | |