Healthcare Provider Details

I. General information

NPI: 1841012093
Provider Name (Legal Business Name): ALEXANDRIA NOELLE BAIRD
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/29/2024
Last Update Date: 10/29/2024
Certification Date: 10/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1209 HARNEY ST STE 105
OMAHA NE
68102-1838
US

IV. Provider business mailing address

2517 SHERIDAN RD
BELLEVUE NE
68123-1965
US

V. Phone/Fax

Practice location:
  • Phone: 140-225-2818
  • Fax: 140-225-2878
Mailing address:
  • Phone: 402-249-3883
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: