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General NPI Number Information
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NPI Number | 1932136165
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Entity Type | Individual
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Provider Name | ROBERT BAIRD PH.D.
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Gender | Male
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Dates
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Enumeration Date | 06/26/2006
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Last Update Date | 01/02/2025
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Provider Practice Location Address
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Address Line | 2851 CHARLEVOIX DR SE STE 323
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City | GRAND RAPIDS
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State | MI
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Zip | 49546-7092
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Country | US
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Telephone | 616-458-0692
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Fax | 616-458-8129
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Provider Business Mailing Address
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Address Line | 161 OTTAWA AVE NW SUITE 300C
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City | GRAND RAPIDS
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State | MI
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Zip | 49503-2700
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Country | US
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Telephone | 616-458-0692
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Fax | 616-458-8129
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 6301012859
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 6301012859
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License Number State | MI
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