Provider Demographics
NPI:1457851982
Name:BAAS, KIRSTEN LYNN (MS OTR/L)
Entity Type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:LYNN
Last Name:BAAS
Suffix:
Gender:F
Credentials:MS OTR/L
Other - Prefix:
Other - First Name:KIRSTEN
Other - Middle Name:LYNN
Other - Last Name:VAAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:21600 OXNARD ST
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367-4976
Mailing Address - Country:US
Mailing Address - Phone:818-345-2345
Mailing Address - Fax:
Practice Address - Street 1:4543 S M 88 HWY
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:MI
Practice Address - Zip Code:49615-9109
Practice Address - Country:US
Practice Address - Phone:231-533-8661
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-21
Last Update Date:2022-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201011634225X00000X
106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician