Provider Demographics
NPI:1376422709
Name:BAKER, MICHELLE ELIZABETH (BS, BCN)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:ELIZABETH
Last Name:BAKER
Suffix:
Gender:F
Credentials:BS, BCN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 216
Mailing Address - Street 2:
Mailing Address - City:AMESBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01913-0005
Mailing Address - Country:US
Mailing Address - Phone:978-880-8310
Mailing Address - Fax:
Practice Address - Street 1:26 MILLYARD STE 7
Practice Address - Street 2:
Practice Address - City:AMESBURY
Practice Address - State:MA
Practice Address - Zip Code:01913-2429
Practice Address - Country:US
Practice Address - Phone:978-880-8310
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-29
Last Update Date:2025-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAMT-12276225700000X
MAE68662472E0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2472E0500XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherEEG
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist