Individual
MRS. JILLEINE RUTH BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
825 WESTERN AVE, COLUMBUS, WI 53925-1675
(920) 623-2520
Mailing address
636 HAMILTON ST, COLUMBUS, WI 53925-1665
(920) 623-4914
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1121-026
WI
Other
Enumeration date
07/27/2006
Last updated
05/02/2008
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