MEDICARE: JULIA BAKER MOT, OTR

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	31005062A	IN

General Provider Information

NPI Number	:	1942936315
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIA BAKER MOT, OTR

Provider Business Mailing Address
First Line	:	2210 WINDSONG CT
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46804-7752
Country	:	US
Telephone Number	:	260-403-7607
Fax Number	:

Provider Business Practice Location Address
First Line	:	2210 WINDSONG CT
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46804-7752
Country	:	US
Telephone Number	:	260-403-7607
Fax Number	:

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

Provider Enumeration Date	:	07/28/2022
Last Update Date	:	07/28/2022

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