Healthcare Provider Details

I. General information

NPI: 1386761963
Provider Name (Legal Business Name): CYNTHIA DORRIS BAER OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2007
Last Update Date: 03/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 LAFAYETTE RD SUITE C
PORTSMOUTH NH
03801-5679
US

IV. Provider business mailing address

PO BOX 442
CHILMARK MA
02535-0442
US

V. Phone/Fax

Practice location:
  • Phone: 603-431-5600
  • Fax: 603-431-5610
Mailing address:
  • Phone: 978-979-4500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number1495
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: