Provider Demographics
NPI:1922332352
Name:BAKER, LAUREN KIMBERLY (ATC)
Entity Type:Individual
Prefix:MS
First Name:LAUREN
Middle Name:KIMBERLY
Last Name:BAKER
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 N VAN DORN ST
Mailing Address - Street 2:404
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22302-1626
Mailing Address - Country:US
Mailing Address - Phone:703-785-2273
Mailing Address - Fax:
Practice Address - Street 1:1555 SOUTHGATE RD
Practice Address - Street 2:SMITH GYM BUILDING 27
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22214-5001
Practice Address - Country:US
Practice Address - Phone:703-614-8759
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-02
Last Update Date:2009-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer