Provider Demographics
NPI:1164264891
Name:BAYNE, CLARA (OTR/L)
Entity type:Individual
Prefix:
First Name:CLARA
Middle Name:
Last Name:BAYNE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:CLARA
Other - Middle Name:DAWN
Other - Last Name:MINDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:67652 224TH ST
Mailing Address - Street 2:
Mailing Address - City:DARWIN
Mailing Address - State:MN
Mailing Address - Zip Code:55324-5212
Mailing Address - Country:US
Mailing Address - Phone:307-746-8991
Mailing Address - Fax:
Practice Address - Street 1:945 CENTURY AVE SW
Practice Address - Street 2:
Practice Address - City:HUTCHINSON
Practice Address - State:MN
Practice Address - Zip Code:55350-3788
Practice Address - Country:US
Practice Address - Phone:320-484-9150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-12
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN107485225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist