Individual
MRS. STACY MICHELLE BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
509 N CARRIER ST, MORGANFIELD, KY 42437-1201
(270) 389-3515
(270) 389-4706
Mailing address
5149 HOUSEBRIDGE RD, CORYDON, KY 42406-9765
(270) 533-3525
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
KY-R3387
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
12500765
—
KY
Enumeration date
07/13/2007
Last updated
07/13/2007
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