Bault, Kelly Jean

Bault, Kelly Jean is an sole proprietor health care provider with primary practice located at 1800 Old West Main St Apt 204 , Carbondale IL 62901-2165. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Developmental Therapist, which is considered as her primary health care specialty. Bault, Kelly Jean can be contacted via phone (815) 343-2776.

Contact Information

Primary practice address
1800 Old West Main St Apt 204 Carbondale IL 62901-2165
Phone: (815) 343-2776
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Developmental Therapist 222Q00000X

Profile Details

NPI number 1467749085
LBN Legal business name Bault, Kelly Jean
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 3rd, 2011
Last updated Jul 3rd, 2011 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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