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NPI Code Detail

MEDICARE: JOSEPH RYAN BAIRD BCBA

MEDICARE: JOSEPH RYAN BAIRD BCBA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst1-18-29317IN

General Provider Information

NPI Number : 1396101812
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSEPH RYAN BAIRD BCBA
Provider Business Mailing Address
First Line : 750 LINCOLN WAY E
Second Line :
City : SOUTH BEND
State : IN
Zip : 46601-3250
Country : US
Telephone Number : 574-786-0088
Fax Number : 574-366-0080
Provider Business Practice Location Address
First Line : 750 LINCOLN WAY E
Second Line :
City : SOUTH BEND
State : IN
Zip : 46601-3250
Country : US
Telephone Number : 574-786-0088
Fax Number : 574-366-0080
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/13/2016
Last Update Date : 06/24/2025

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