Individual
TAYLOR MARIE BALDRIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1727 SHAWANO AVE, GREEN BAY, WI 54303-3268
(920) 496-4700
Mailing address
2477 CURTIS CT, GREEN BAY, WI 54311-6753
(262) 501-6504
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
726426
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
726426
WI STATE
WI
Enumeration date
04/15/2022
Last updated
10/12/2022
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