Provider Demographics
NPI:1194783613
Name:BAKER, TAMARA K (MS, OTR/L)
Entity type:Individual
Prefix:MS
First Name:TAMARA
Middle Name:K
Last Name:BAKER
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1530 PARHAM POINTE DR
Mailing Address - Street 2:APT. 14-O
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72204-2420
Mailing Address - Country:US
Mailing Address - Phone:501-960-4612
Mailing Address - Fax:501-223-8998
Practice Address - Street 1:1 TREASURE HILL RD
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-2219
Practice Address - Country:US
Practice Address - Phone:501-223-8996
Practice Address - Fax:501-223-8998
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-03
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROTR-1752225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist