Individual
MRS. LYDA A BAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
951 W SELDON RD APT 3, WASILLA, AK 99654-3464
(907) 884-6604
Mailing address
1231 W NORTHERN LIGHTS BLVD # 830, ANCHORAGE, AK 99503-2337
(907) 884-6604
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
2002
AK
225XP0200X
Pediatric Occupational Therapist
Primary
2002
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00071986
—
NM
01
—
2002
OT LISCENSE
AK
Enumeration date
02/28/2007
Last updated
12/28/2012
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