Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225XG0600X | Occupational Therapist - Gerontology | 103102 | MN |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 103102 | MN |
Y | 225XP0200X | Occupational Therapist - Pediatrics | 103102 | MN |
NPI | 1891024238 |
---|---|
Provider Name | Sara Beth Baldwin |
First Address | Apo, AP 96205-5244 |
Second Address | Apo, AP 96205-5244 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/12/2009 |
Last Update Date | 14/12/2009 |