Provider Demographics
NPI:1295534725
Name:BAIRD, KATHRYN LEIGH (LMT CNS CPT)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:LEIGH
Last Name:BAIRD
Suffix:
Gender:
Credentials:LMT CNS CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1870 COPPER KETTLE LN
Mailing Address - Street 2:
Mailing Address - City:DUNEDIN
Mailing Address - State:FL
Mailing Address - Zip Code:34698-4808
Mailing Address - Country:US
Mailing Address - Phone:727-798-6836
Mailing Address - Fax:
Practice Address - Street 1:28059 US 19 N STE 303A
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33761-2620
Practice Address - Country:US
Practice Address - Phone:727-939-6095
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-08
Last Update Date:2025-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL102284225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist