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NPI Code Detail

MEDICARE: MRS. ALISSA BAKER M.S., OTR/L

MEDICARE: MRS. ALISSA BAKER M.S., 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 Therapist5201008720MI

General Provider Information

NPI Number : 1770907560
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ALISSA BAKER M.S., OTR/L
Provider Business Mailing Address
First Line : 5150 WARDCLIFF DR
Second Line :
City : EAST LANSING
State : MI
Zip : 48823-3851
Country : US
Telephone Number : 517-664-5320
Fax Number :
Provider Business Practice Location Address
First Line : 5150 WARDCLIFF DR
Second Line :
City : EAST LANSING
State : MI
Zip : 48823-3851
Country : US
Telephone Number : 517-664-5320
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/13/2014
Last Update Date : 09/10/2014

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