Provider Demographics
NPI:1619297090
Name:BAKER, JOANNE (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JOANNE
Middle Name:
Last Name:BAKER
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20692 SAEGER RD
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE SPRINGS
Mailing Address - State:PA
Mailing Address - Zip Code:16403-5452
Mailing Address - Country:US
Mailing Address - Phone:814-763-2445
Mailing Address - Fax:
Practice Address - Street 1:20881 STATE HWY 198
Practice Address - Street 2:
Practice Address - City:SAEGERTOWN
Practice Address - State:PA
Practice Address - Zip Code:16433-6159
Practice Address - Country:US
Practice Address - Phone:814-763-2445
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-08
Last Update Date:2010-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL009206235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist