Provider Demographics
NPI:1861644064
Name:BAIRD, TERESA (OT)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:
Last Name:BAIRD
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 MEDICAL DRIVE
Mailing Address - Street 2:LIFESPAN THERAPY
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032
Mailing Address - Country:US
Mailing Address - Phone:317-573-1037
Mailing Address - Fax:
Practice Address - Street 1:725 BELL TRACE CIRCLE
Practice Address - Street 2:BELL TRACE HEALTH & LIVING COMMUNITY
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47408-4408
Practice Address - Country:US
Practice Address - Phone:812-323-2858
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-21
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31003629A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist