Provider Demographics
NPI:1023132586
Name:BAKER, JENNIFER ANNETTE (MA)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:ANNETTE
Last Name:BAKER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
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Mailing Address - Street 1:138 TALL TIMBERS LN
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:KY
Mailing Address - Zip Code:42633-3248
Mailing Address - Country:US
Mailing Address - Phone:606-219-3155
Mailing Address - Fax:606-348-7241
Practice Address - Street 1:138 TALL TIMBERS LN
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:KY
Practice Address - Zip Code:42633-3248
Practice Address - Country:US
Practice Address - Phone:606-219-3155
Practice Address - Fax:606-348-7241
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2016-06-06
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist