Provider Demographics
NPI:1184120461
Name:BAKER, PAULA (ATC)
Entity type:Individual
Prefix:
First Name:PAULA
Middle Name:
Last Name:BAKER
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:PAULA
Other - Middle Name:
Other - Last Name:WOLLENSLEGEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5736 STATE ROUTE 101 E
Mailing Address - Street 2:
Mailing Address - City:CLYDE
Mailing Address - State:OH
Mailing Address - Zip Code:43410-9717
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5736 STATE ROUTE 101 E
Practice Address - Street 2:
Practice Address - City:CLYDE
Practice Address - State:OH
Practice Address - Zip Code:43410-9717
Practice Address - Country:US
Practice Address - Phone:419-547-6555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-04
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer