Provider Demographics
NPI:1689713471
Name:BAKER, BRIGID DURKIN (OTRL)
Entity Type:Individual
Prefix:
First Name:BRIGID
Middle Name:DURKIN
Last Name:BAKER
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:BRIGID
Other - Middle Name:
Other - Last Name:DURKIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2301 RESEARCH BLVD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-3204
Mailing Address - Country:US
Mailing Address - Phone:301-424-5200
Mailing Address - Fax:
Practice Address - Street 1:2301 RESEARCH BLVD
Practice Address - Street 2:SUITE 110
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-3204
Practice Address - Country:US
Practice Address - Phone:301-424-5200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2009-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD02856225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDH258M899Medicare ID - Type Unspecified