Individual
AMANDA BROOKE BAKER I
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSOT, OTR/L
Contact information
Practice address
1607 JEFFERSON ST, CHATTANOOGA, TN 37408-2127
(423) 443-0727
Mailing address
1607 JEFFERSON ST, CHATTANOOGA, TN 37408-2127
(423) 443-0727
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
4710
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4710
STATE OF TENNESSEE
TN
Enumeration date
12/05/2018
Last updated
12/05/2018
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