Provider Demographics
NPI:1326034570
Name:BAIR, PATRICIA (LISW)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:
Last Name:BAIR
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8440
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43623-0440
Mailing Address - Country:US
Mailing Address - Phone:419-885-0200
Mailing Address - Fax:419-885-0203
Practice Address - Street 1:2340 DETROIT AVE STE C1
Practice Address - Street 2:
Practice Address - City:MAUMEE
Practice Address - State:OH
Practice Address - Zip Code:43537-3794
Practice Address - Country:US
Practice Address - Phone:419-346-5752
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-23
Last Update Date:2011-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI-0001329104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHBASW26472Medicare PIN