Provider Demographics
NPI:1245469048
Name:BAER, DONNA JEAN (OTR/L)
Entity type:Individual
Prefix:MISS
First Name:DONNA
Middle Name:JEAN
Last Name:BAER
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 1:8406 LAKE RD
Mailing Address - Street 2:
Mailing Address - City:BARKER
Mailing Address - State:NY
Mailing Address - Zip Code:14012-9608
Mailing Address - Country:US
Mailing Address - Phone:270-790-7882
Mailing Address - Fax:
Practice Address - Street 1:2990 RAVINES RD.
Practice Address - Street 2:
Practice Address - City:MIDDLEBURG
Practice Address - State:FL
Practice Address - Zip Code:32068
Practice Address - Country:US
Practice Address - Phone:254-702-8042
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-14
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT15303225X00000X
IL056.008233225X00000X
AK2401225X00000X
KYR5146225X00000X
NY022515225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist