Provider Demographics
NPI:1326836768
Name:BAER, JAMIE M (COTA/L)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:M
Last Name:BAER
Suffix:
Gender:
Credentials:COTA/L
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:M
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:COTA/L
Mailing Address - Street 1:807 S 130 E APT J201
Mailing Address - Street 2:
Mailing Address - City:VERNAL
Mailing Address - State:UT
Mailing Address - Zip Code:84078-4548
Mailing Address - Country:US
Mailing Address - Phone:480-390-5669
Mailing Address - Fax:
Practice Address - Street 1:80 N VERNAL AVE
Practice Address - Street 2:
Practice Address - City:VERNAL
Practice Address - State:UT
Practice Address - Zip Code:84078-2104
Practice Address - Country:US
Practice Address - Phone:435-299-2399
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-26
Last Update Date:2025-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZOTA-005393224Z00000X
CA5711224Z00000X
UT13444898-4202224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant