Provider Demographics
NPI:1770912586
Name:BAIRD, KATHERINE THERESE (MAT, BCBA, LBA)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:THERESE
Last Name:BAIRD
Suffix:
Gender:F
Credentials:MAT, BCBA, LBA
Other - Prefix:
Other - First Name:KATE
Other - Middle Name:
Other - Last Name:BAIRD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MAT, BCBA, LBA
Mailing Address - Street 1:542 AMHERST ST
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03063-1016
Mailing Address - Country:US
Mailing Address - Phone:844-902-4222
Mailing Address - Fax:
Practice Address - Street 1:112 LONG HOLLOW PIKE UNIT A
Practice Address - Street 2:
Practice Address - City:GOODLETTSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37072-1840
Practice Address - Country:US
Practice Address - Phone:844-765-6842
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-03
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1017103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst