Provider Demographics
NPI:1154517969
Name:BAKER GOULET, LAURA MARIE (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:MARIE
Last Name:BAKER GOULET
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:64 EXETER RD
Mailing Address - Street 2:
Mailing Address - City:CORINTH
Mailing Address - State:ME
Mailing Address - Zip Code:04427-3050
Mailing Address - Country:US
Mailing Address - Phone:207-659-1453
Mailing Address - Fax:
Practice Address - Street 1:64 EXETER RD
Practice Address - Street 2:
Practice Address - City:CORINTH
Practice Address - State:ME
Practice Address - Zip Code:04427-3050
Practice Address - Country:US
Practice Address - Phone:207-659-1453
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-15
Last Update Date:2019-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOT568225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics