Provider Demographics
NPI:1942936315
Name:BAKER, JULIA (MOT, OTR)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:BAKER
Suffix:
Gender:F
Credentials:MOT, OTR
Other - Prefix:
Other - First Name:JULIA
Other - Middle Name:
Other - Last Name:DUNKELBERGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2210 WINDSONG CT
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46804-7752
Mailing Address - Country:US
Mailing Address - Phone:260-403-7607
Mailing Address - Fax:
Practice Address - Street 1:2210 WINDSONG CT
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46804-7752
Practice Address - Country:US
Practice Address - Phone:260-403-7607
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-28
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31005062A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist