Provider Demographics
NPI:1578619565
Name:BAKER, CHRISTI S (SLP)
Entity Type:Individual
Prefix:
First Name:CHRISTI
Middle Name:S
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 1:1601 E BROADWAY
Mailing Address - Street 2:BOX 33
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65201-8020
Mailing Address - Country:US
Mailing Address - Phone:573-815-3868
Mailing Address - Fax:573-815-2605
Practice Address - Street 1:1601 E BROADWAY
Practice Address - Street 2:BOX 33
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65201-8020
Practice Address - Country:US
Practice Address - Phone:573-815-3868
Practice Address - Fax:573-815-2605
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO112140235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist