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NPI Code Detail

MEDICARE: SHELLEY S BAKER OTR/L

MEDICARE: SHELLEY S BAKER OTR/L
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
1225X00000XOccupational Therapist000017MO
2225X00000XOccupational Therapist17-00419KS

General Provider Information

NPI Number : 1053409011
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHELLEY S BAKER OTR/L
Provider Business Mailing Address
First Line : 3915 W 90TH TER
Second Line :
City : PRAIRIE VILLAGE
State : KS
Zip : 66207-2329
Country : US
Telephone Number : 913-381-1326
Fax Number : 913-381-2673
Provider Business Practice Location Address
First Line : 7501 PROSPECT AVE
Second Line :
City : KANSAS CITY
State : MO
Zip : 64132-2103
Country : US
Telephone Number : 816-421-5848
Fax Number : 816-237-2065
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/11/2006
Last Update Date : 07/08/2007

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Directions to “ SHELLEY S BAKER OTR/L” Practice Location

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