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NPI 1427481431

NPI 1427481431 : DAVID M BAIRD LCSW : BOISE, ID

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General NPI Number Information
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    NPI Number           |    1427481431
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    Entity Type          |    Individual 
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    Provider Name        |    DAVID M BAIRD LCSW
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    08/13/2013
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    Last Update Date     |    10/13/2023
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Provider Practice Location Address
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    Address Line         |    444 W FORT ST. CRH 2ND FLOOR
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    City                 |    BOISE
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    State                |    ID
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    Zip                  |    83702-4535
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    Country              |    US
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    Telephone            |    208-422-1018
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    15323 N SHERIDAN ST 
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    City                 |    MEAD
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    State                |    WA
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    Zip                  |    99021-9562
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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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        |    1041C0700X
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    Taxonomy Name        |    Clinical Social Worker
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    License Number       |    LW60085546
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    License Number State |    WA
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