Provider Demographics
NPI:1275761660
Name:BAKER, KATHERINE MAXWELL (SLP)
Entity Type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:MAXWELL
Last Name:BAKER
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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:
Is Sole Proprietor?:No
Enumeration Date:2009-06-24
Last Update Date:2013-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202004238235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist