Provider Demographics
NPI:1669801197
Name:BAKER, JESSICA L (PT, DPT)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:L
Last Name:BAKER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:395 OLD LANDING RD STE 102
Mailing Address - Street 2:
Mailing Address - City:MILLSBORO
Mailing Address - State:DE
Mailing Address - Zip Code:19966-1249
Mailing Address - Country:US
Mailing Address - Phone:302-934-3922
Mailing Address - Fax:
Practice Address - Street 1:395 OLD LANDING RD STE 102
Practice Address - Street 2:
Practice Address - City:MILLSBORO
Practice Address - State:DE
Practice Address - Zip Code:19966-1249
Practice Address - Country:US
Practice Address - Phone:302-934-3922
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-05
Last Update Date:2025-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEJ1-0014758225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist