Individual
TRACEY A BAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
2022 S 67TH ST, PHILADELPHIA, PA 19142-1625
(215) 729-4016
Mailing address
2022 S 67TH ST, PHILADELPHIA, PA 19142-1625
(215) 729-4016
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OP002889L
PA
Other
Enumeration date
06/30/2009
Last updated
06/30/2009
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