Individual
GWENDOLYN BAIRD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
245 N 3RD E, MT HOME, ID 83647-2734
(208) 587-8255
(208) 587-4475
Mailing address
2268 E COURTLAND DR, EAGLE, ID 83616-6194
(208) 761-2618
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT-542
ID
Other
Enumeration date
10/14/2015
Last updated
10/14/2015
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