MEDICARE: MRS. KIMBERLY GAIL BAKER

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
1	225X00000X	Occupational Therapist	5581	MA

General Provider Information

NPI Number	:	1043418478
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KIMBERLY GAIL BAKER

Provider Business Mailing Address
First Line	:	2 MARSHALL ST
Second Line	:
City	:	NORTH READING
State	:	MA
Zip	:	01864-3023
Country	:	US
Telephone Number	:	978-664-3305
Fax Number	:

Provider Business Practice Location Address
First Line	:	2 MARSHALL ST
Second Line	:
City	:	NORTH READING
State	:	MA
Zip	:	01864-3023
Country	:	US
Telephone Number	:	978-664-3305
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/06/2007
Last Update Date	:	07/08/2007

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