Provider Demographics
NPI:1942963954
Name:BAUGH, UNIQUA OLIVIA (MMP, SPM)
Entity Type:Individual
Prefix:MS
First Name:UNIQUA
Middle Name:OLIVIA
Last Name:BAUGH
Suffix:
Gender:F
Credentials:MMP, SPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4318 OLD HUNDRED RD STE B
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23831-4231
Mailing Address - Country:US
Mailing Address - Phone:804-895-8096
Mailing Address - Fax:
Practice Address - Street 1:4318 OLD HUNDRED RD STE B
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:VA
Practice Address - Zip Code:23831
Practice Address - Country:US
Practice Address - Phone:804-895-8096
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-16
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0019017419225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist