Provider Demographics
NPI:1629360649
Name:BAIRD, KATHRYN ANN MARIE (LPC)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:ANN MARIE
Last Name:BAIRD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6136 FRISCO SQUARE BLVD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-3246
Mailing Address - Country:US
Mailing Address - Phone:214-537-0025
Mailing Address - Fax:972-534-1595
Practice Address - Street 1:6136 FRISCO SQUARE BLVD
Practice Address - Street 2:SUITE 400
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-3246
Practice Address - Country:US
Practice Address - Phone:214-537-0025
Practice Address - Fax:972-534-1595
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-10
Last Update Date:2011-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX65451101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health