Provider Demographics
NPI:1902051584
Name:BALDWIN, JOAN E (RPT)
Entity type:Individual
Prefix:MS
First Name:JOAN
Middle Name:E
Last Name:BALDWIN
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:JOAN
Other - Middle Name:BALDWIN
Other - Last Name:CHECCA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:5119 DYEMEADOW CT
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-2313
Mailing Address - Country:US
Mailing Address - Phone:739-650-1452
Mailing Address - Fax:
Practice Address - Street 1:5119 DYEMEADOW CT
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-2313
Practice Address - Country:US
Practice Address - Phone:973-650-1452
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-24
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJQA090692251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics