Provider Demographics
NPI:1972338424
Name:BAILLARGEON, WILLIAM ROSS (MA)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:ROSS
Last Name:BAILLARGEON
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1267 SAINT CLAIR AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55105-2818
Mailing Address - Country:US
Mailing Address - Phone:715-441-3059
Mailing Address - Fax:
Practice Address - Street 1:1267 SAINT CLAIR AVE
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55105-2818
Practice Address - Country:US
Practice Address - Phone:715-441-3059
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-04
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health