Individual
LACEY BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1801 S 4J RD, GILLETTE, WY 82718-5201
(307) 682-2392
Mailing address
1801 S 4J RD, GILLETTE, WY 82718-5201
(307) 682-2392
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTR-762
WY
Other
Enumeration date
03/01/2017
Last updated
03/01/2017
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