Provider Demographics
NPI:1891316428
Name:BAKER, DANELLE DENISE (MOTR/L)
Entity Type:Individual
Prefix:
First Name:DANELLE
Middle Name:DENISE
Last Name:BAKER
Suffix:
Gender:F
Credentials:MOTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1439 HUDSON ST APT 1
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32301-4356
Mailing Address - Country:US
Mailing Address - Phone:941-962-3880
Mailing Address - Fax:
Practice Address - Street 1:1439 HUDSON ST APT 1
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32301-4356
Practice Address - Country:US
Practice Address - Phone:941-962-3880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-05
Last Update Date:2020-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT20251225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist