Provider Demographics
NPI:1003199514
Name:BAIRD, KATHLEEN FRANCES (PHD)
Entity Type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:FRANCES
Last Name:BAIRD
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2249 WILDWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43614-4176
Mailing Address - Country:US
Mailing Address - Phone:419-382-5766
Mailing Address - Fax:
Practice Address - Street 1:2249 WILDWOOD BLVD
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43614-4176
Practice Address - Country:US
Practice Address - Phone:419-382-5766
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-21
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5722103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical