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NPI Code Detail

MEDICARE: MRS. JENNIFER JO BAKER MA-CCC/SLP-L

MEDICARE:  MRS. JENNIFER JO BAKER  MA-CCC/SLP-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
1235Z00000XSpeech-Language Pathologist22004212AIN

General Provider Information

NPI Number : 1598167306
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JENNIFER JO BAKER MA-CCC/SLP-L
Provider Business Mailing Address
First Line : 1100 ALLISON ST
Second Line :
City : CROWN POINT
State : IN
Zip : 46307-7874
Country : US
Telephone Number : 219-743-3302
Fax Number : 219-661-0470
Provider Business Practice Location Address
First Line : 1100 ALLISON ST
Second Line :
City : CROWN POINT
State : IN
Zip : 46307-7874
Country : US
Telephone Number : 219-743-3302
Fax Number : 219-661-0470
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/23/2014
Last Update Date : 08/03/2016

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Directions to “ MRS. JENNIFER JO BAKER MA-CCC/SLP-L” Practice Location

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