Provider Demographics
NPI:1083878573
Name:BAKER, EVE JUDITH (LMT)
Entity Type:Individual
Prefix:
First Name:EVE
Middle Name:JUDITH
Last Name:BAKER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:68 OVERLOOK DR
Mailing Address - Street 2:
Mailing Address - City:BRATTLEBORO
Mailing Address - State:VT
Mailing Address - Zip Code:05301-4301
Mailing Address - Country:US
Mailing Address - Phone:802-251-6059
Mailing Address - Fax:
Practice Address - Street 1:72 COTTON MILL HL
Practice Address - Street 2:B-103
Practice Address - City:BRATTLEBORO
Practice Address - State:VT
Practice Address - Zip Code:05301-7170
Practice Address - Country:US
Practice Address - Phone:802-251-6059
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-14
Last Update Date:2010-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0146917-1225700000X
NJ26BT00010300225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist