Provider Demographics
NPI:1972266914
Name:BAKER, KAREN ELISE (OTR/L)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:ELISE
Last Name:BAKER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3114 WOODVIEW RIDGE DR APT 207
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66103-3607
Mailing Address - Country:US
Mailing Address - Phone:573-253-1542
Mailing Address - Fax:
Practice Address - Street 1:15917 ANTIOCH RD
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66223-2924
Practice Address - Country:US
Practice Address - Phone:913-239-9539
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-17
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225X00000X
MO2021035812225X00000X
KS17-03932225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist