Provider Demographics
NPI:1710488960
Name:BAAS, ERICA (OTR)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:BAAS
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8530 WHITTALL ST NE
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:MI
Mailing Address - Zip Code:49341-7626
Mailing Address - Country:US
Mailing Address - Phone:616-813-5085
Mailing Address - Fax:
Practice Address - Street 1:814 E LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:IONIA
Practice Address - State:MI
Practice Address - Zip Code:48846-1314
Practice Address - Country:US
Practice Address - Phone:616-527-0080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-23
Last Update Date:2018-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201009362225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist