Individual
AUBRIE MICHELLE BAACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOT, OTR
Contact information
Practice address
3840 HULEN ST, FORT WORTH, TX 76107-7277
(817) 335-3022
Mailing address
PO BOX 2603, FT WORTH, TX 76107
(817) 335-4022
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
111799
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
332789202
—
TX
01
—
8TAB60
BCBS
TX
Enumeration date
05/04/2007
Last updated
12/15/2022
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