Provider Demographics
NPI:1740519271
Name:BAKER, ARLENE ANN
Entity type:Individual
Prefix:MS
First Name:ARLENE
Middle Name:ANN
Last Name:BAKER
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:ARLENE
Other - Middle Name:ANN
Other - Last Name:MACHNIK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CCC-SLP
Mailing Address - Street 1:735 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04106-6809
Mailing Address - Country:US
Mailing Address - Phone:207-210-7861
Mailing Address - Fax:
Practice Address - Street 1:735 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:SOUTH PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04106-6809
Practice Address - Country:US
Practice Address - Phone:207-210-7861
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-11
Last Update Date:2009-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME02235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist