Provider Demographics
NPI:1073096392
Name:BAKER, ALYSSA JOY (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:ALYSSA
Middle Name:JOY
Last Name:BAKER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12827 W ARIZONA PL
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80228-3558
Mailing Address - Country:US
Mailing Address - Phone:130-351-9735
Mailing Address - Fax:
Practice Address - Street 1:12827 W ARIZONA PL
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80228-3558
Practice Address - Country:US
Practice Address - Phone:130-351-9735
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-12
Last Update Date:2018-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225X00000X
CO0004473225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist