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NPI Code Detail

MEDICARE: MR. JEFFREY P BAIRD LPC

MEDICARE: MR. JEFFREY P BAIRD LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor5010899-6004UT

General Provider Information

NPI Number : 1750434049
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JEFFREY P BAIRD LPC
Provider Business Mailing Address
First Line : 1789 SOUTH 400 EAST
Second Line :
City : KAYSVILLE
State : UT
Zip : 84037
Country : US
Telephone Number : 801-721-1202
Fax Number :
Provider Business Practice Location Address
First Line : 3518 WASHINGTON BLVD
Second Line :
City : OGDEN
State : UT
Zip : 84403-1034
Country : US
Telephone Number : 801-399-1600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/19/2007
Last Update Date : 07/08/2007

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