Individual
JESSICA NICOLE BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
102 N JACKSON ST, NEWTON, IL 62448-1900
(618) 783-7529
Mailing address
3198 OWL RD, LOUISVILLE, IL 62858-2597
(618) 231-1877
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056.012923
IL
225X00000X
Occupational Therapist
31006826A
IN
Other
Enumeration date
02/20/2019
Last updated
02/23/2019
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