Provider Demographics
NPI:1528285590
Name:BAIRD, SHARON KAY
Entity type:Individual
Prefix:MS
First Name:SHARON
Middle Name:KAY
Last Name:BAIRD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:MARYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62062-5681
Mailing Address - Country:US
Mailing Address - Phone:618-288-9530
Mailing Address - Fax:618-288-9276
Practice Address - Street 1:109 RIDGE DR
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:IL
Practice Address - Zip Code:62062-5681
Practice Address - Country:US
Practice Address - Phone:618-288-9530
Practice Address - Fax:618-288-9276
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist