Provider Demographics
NPI:1861822215
Name:BAIRD, CORI (SPEECH PATHOLOGIST)
Entity Type:Individual
Prefix:
First Name:CORI
Middle Name:
Last Name:BAIRD
Suffix:
Gender:F
Credentials:SPEECH PATHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:190 CIVIC CIR
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75067-3424
Mailing Address - Country:US
Mailing Address - Phone:972-219-1200
Mailing Address - Fax:
Practice Address - Street 1:190 CIVIC CIR
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067-3424
Practice Address - Country:US
Practice Address - Phone:972-219-1200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-22
Last Update Date:2013-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX100174235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist