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Individual

DR. SUSAN CHRISTINE BAIRD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
2632 S 11TH ST, KALAMAZOO, MI 49009-2106
(269) 873-8002
Mailing address
2632 S 11TH ST, KALAMAZOO, MI 49009-2106

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301012476
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11608898
CAQH PROVIDER ID
MI
01
6301012476
PROFESSIONAL LICENSE NUMB
MI
01
68-0-C9-1310-0
BCBSM PIN
MI
Enumeration date
02/18/2007
Last updated
11/29/2023
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