Provider Demographics
NPI:1386208338
Name:BALDWIN, ELIZABETH HARVEY (OTR/L)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:HARVEY
Last Name:BALDWIN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:ANN
Other - Last Name:HARVEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:105 W CLEARVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:WORTHINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43085-4111
Mailing Address - Country:US
Mailing Address - Phone:512-569-5039
Mailing Address - Fax:
Practice Address - Street 1:30 NORTHWOODS BLVD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43235-4716
Practice Address - Country:US
Practice Address - Phone:614-545-8300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-25
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5901225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
106487OtherNATIONAL BOARD OF CERTIFICATION IN OCCUPATIONAL THERAPY
OHOT-5901OtherSTATE OF OHIO OCCUPATIONAL THERAPY SECTION