Individual
ELLISA LONG BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
4900 UNIVERSITY SQ STE 24, HUNTSVILLE, AL 35816-1829
(256) 387-7415
Mailing address
251 BOLES RD, HAZEL GREEN, AL 35750-8429
(256) 585-4786
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
5202
AL
Other
Enumeration date
06/15/2020
Last updated
06/15/2020
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