Individual
MRS. LISA LOUISE BAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
8903 N 121ST EAST AVE, OWASSO, OK 74055-2026
(918) 645-0375
Mailing address
8903 N 121ST EAST AVE, OWASSO, OK 74055-2026
(918) 645-0375
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A207
OK
Other
Enumeration date
10/09/2014
Last updated
10/09/2014
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