Provider Demographics
NPI:1386049047
Name:KATHERINE M. BAKER, LLC
Entity type:Organization
Organization Name:KATHERINE M. BAKER, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:MAXWELL
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:571-257-8807
Mailing Address - Street 1:901 N WASHINGTON ST
Mailing Address - Street 2:SUITE 500
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22314-5509
Mailing Address - Country:US
Mailing Address - Phone:571-257-8807
Mailing Address - Fax:
Practice Address - Street 1:901 N WASHINGTON ST
Practice Address - Street 2:SUITE 500
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-5509
Practice Address - Country:US
Practice Address - Phone:571-257-8807
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-23
Last Update Date:2014-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202004238235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty