Provider Demographics
NPI:1013553429
Name:BAKER, SIDNEY J
Entity type:Individual
Prefix:
First Name:SIDNEY
Middle Name:J
Last Name:BAKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SIDNEY
Other - Middle Name:
Other - Last Name:DREW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:22120 MIDLAND DR STE 1
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:KS
Mailing Address - Zip Code:66226-3554
Mailing Address - Country:US
Mailing Address - Phone:913-745-4064
Mailing Address - Fax:913-745-4352
Practice Address - Street 1:401 NW MURRAY RD
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64081-1425
Practice Address - Country:US
Practice Address - Phone:816-944-4244
Practice Address - Fax:816-944-4245
Is Sole Proprietor?:No
Enumeration Date:2019-11-20
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2019041710225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist