Provider Demographics
NPI:1548485543
Name:BALDWIN, HOLLIE BETH (OT)
Entity type:Individual
Prefix:MS
First Name:HOLLIE
Middle Name:BETH
Last Name:BALDWIN
Suffix:
Gender:F
Credentials:OT
Other - Prefix:MISS
Other - First Name:HOLLIE
Other - Middle Name:BETH
Other - Last Name:BEEMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:45 LYON ST
Mailing Address - Street 2:
Mailing Address - City:BATH
Mailing Address - State:NY
Mailing Address - Zip Code:14810-1125
Mailing Address - Country:US
Mailing Address - Phone:607-968-0515
Mailing Address - Fax:
Practice Address - Street 1:7571 STATE ROUTE 54
Practice Address - Street 2:REHAB SERVICES DEPT, IRA DAVENPORT MEMORIAL HOSPITAL
Practice Address - City:BATH
Practice Address - State:NY
Practice Address - Zip Code:14810-9504
Practice Address - Country:US
Practice Address - Phone:607-776-8543
Practice Address - Fax:607-776-8635
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011140-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist