Provider Demographics
NPI:1932746658
Name:BAUGHMAN, ELIZABETH SIDNEY
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:SIDNEY
Last Name:BAUGHMAN
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 1:517 W ELM ST
Mailing Address - Street 2:
Mailing Address - City:WAYLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49348-1079
Mailing Address - Country:US
Mailing Address - Phone:269-290-3130
Mailing Address - Fax:
Practice Address - Street 1:517 W ELM ST
Practice Address - Street 2:
Practice Address - City:WAYLAND
Practice Address - State:MI
Practice Address - Zip Code:49348-1079
Practice Address - Country:US
Practice Address - Phone:269-290-3130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-01
Last Update Date:2019-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker