Provider Demographics
NPI:1366684797
Name:BAKER, MELISSA D (OTR)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:D
Last Name:BAKER
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 OLIVE ST SW
Mailing Address - Street 2:
Mailing Address - City:CULLMAN
Mailing Address - State:AL
Mailing Address - Zip Code:35055-7202
Mailing Address - Country:US
Mailing Address - Phone:256-739-1430
Mailing Address - Fax:256-775-0310
Practice Address - Street 1:245 CAHABA VALLEY PKWY STE 200
Practice Address - Street 2:
Practice Address - City:PELHAM
Practice Address - State:AL
Practice Address - Zip Code:35124-2217
Practice Address - Country:US
Practice Address - Phone:205-942-6820
Practice Address - Fax:205-942-5884
Is Sole Proprietor?:No
Enumeration Date:2009-03-31
Last Update Date:2009-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2588225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist