Provider Demographics
NPI:1508350521
Name:BAKER, CHRISTINE (OTD/OTR)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:BAKER
Suffix:
Gender:F
Credentials:OTD/OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:723 WASHINGTON ST APT 4
Mailing Address - Street 2:
Mailing Address - City:WAUSAU
Mailing Address - State:WI
Mailing Address - Zip Code:54403-5668
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:520 N 28TH AVE STE 100
Practice Address - Street 2:
Practice Address - City:WAUSAU
Practice Address - State:WI
Practice Address - Zip Code:54401-4101
Practice Address - Country:US
Practice Address - Phone:715-843-1058
Practice Address - Fax:715-843-1059
Is Sole Proprietor?:No
Enumeration Date:2018-06-22
Last Update Date:2021-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist