Provider Demographics
NPI:1083098511
Name:BAIRD, KATHERINE FREEMAN (PT,)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:FREEMAN
Last Name:BAIRD
Suffix:
Gender:F
Credentials:PT,
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:FREEMAN
Other - Last Name:BAIRD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:55 AUDUBON LAKE DR
Mailing Address - Street 2:
Mailing Address - City:MANDEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70471-8216
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1350 PARK DR
Practice Address - Street 2:
Practice Address - City:MANDEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70471-3205
Practice Address - Country:US
Practice Address - Phone:985-869-6503
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-15
Last Update Date:2015-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA08229R225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist