Provider Demographics
NPI:1720797533
Name:BAKER, LAUREN ANN (OT)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:ANN
Last Name:BAKER
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2385 LINKENHOLT DR
Mailing Address - Street 2:
Mailing Address - City:COLLIERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38017-8823
Mailing Address - Country:US
Mailing Address - Phone:586-201-6844
Mailing Address - Fax:
Practice Address - Street 1:2385 LINKENHOLT DR
Practice Address - Street 2:
Practice Address - City:COLLIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:38017-8823
Practice Address - Country:US
Practice Address - Phone:586-201-6844
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-21
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5893225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist