Provider Demographics
NPI:1831654797
Name:BAKER, PALMA C
Entity Type:Individual
Prefix:
First Name:PALMA
Middle Name:C
Last Name:BAKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 CENTERPOINT PKWY
Mailing Address - Street 2:
Mailing Address - City:PONTIAC
Mailing Address - State:MI
Mailing Address - Zip Code:48341-3116
Mailing Address - Country:US
Mailing Address - Phone:248-857-6776
Mailing Address - Fax:248-857-7102
Practice Address - Street 1:3000 CENTERPOINT PKWY
Practice Address - Street 2:
Practice Address - City:PONTIAC
Practice Address - State:MI
Practice Address - Zip Code:48341-3116
Practice Address - Country:US
Practice Address - Phone:248-857-6776
Practice Address - Fax:248-857-7102
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-05
Last Update Date:2019-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7101003336235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist