Healthcare Provider Details

I. General information

NPI: 1316206154
Provider Name (Legal Business Name): HEATHER MARIE BAIR M.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2012
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 WALNUT ST
FORT COLLINS CO
80524-2485
US

IV. Provider business mailing address

204 WALNUT ST
FORT COLLINS CO
80524-2485
US

V. Phone/Fax

Practice location:
  • Phone: 512-740-4621
  • Fax:
Mailing address:
  • Phone: 512-740-4621
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: