Provider Demographics
NPI:1811228885
Name:BAKER, LINDA GIMBLE (MS OTR)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:GIMBLE
Last Name:BAKER
Suffix:
Gender:F
Credentials:MS OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20839 ROAD W
Mailing Address - Street 2:
Mailing Address - City:LEWIS
Mailing Address - State:CO
Mailing Address - Zip Code:81327-9615
Mailing Address - Country:US
Mailing Address - Phone:970-882-4794
Mailing Address - Fax:970-565-1203
Practice Address - Street 1:20839 ROAD W
Practice Address - Street 2:
Practice Address - City:LEWIS
Practice Address - State:CO
Practice Address - Zip Code:81327-9615
Practice Address - Country:US
Practice Address - Phone:970-882-4794
Practice Address - Fax:970-565-1203
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-14
Last Update Date:2011-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2416225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist