Provider Demographics
NPI:1730467176
Name:BAIRD, ELIZABETH J (MACCC-SLP)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:J
Last Name:BAIRD
Suffix:
Gender:F
Credentials:MACCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:68 FIELDSTONE DR
Mailing Address - Street 2:
Mailing Address - City:WILTON
Mailing Address - State:NY
Mailing Address - Zip Code:12831-1715
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:432 WESTERN AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12203-1400
Practice Address - Country:US
Practice Address - Phone:518-454-5263
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-03
Last Update Date:2017-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011147-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist