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General NPI Number Information
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NPI Number | 1396101812
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Entity Type | Individual
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Provider Name | JOSEPH RYAN BAIRD BCBA
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Gender | Male
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Dates
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Enumeration Date | 01/13/2016
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Last Update Date | 06/24/2025
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Provider Practice Location Address
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Address Line | 750 LINCOLN WAY E
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City | SOUTH BEND
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State | IN
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Zip | 46601-3250
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Country | US
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Telephone | 574-786-0088
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Fax | 574-366-0080
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Provider Business Mailing Address
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Address Line | 750 LINCOLN WAY E
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City | SOUTH BEND
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State | IN
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Zip | 46601-3250
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Country | US
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Telephone | 574-786-0088
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Fax | 574-366-0080
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-18-29317
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License Number State | IN
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