Provider Demographics
NPI:1831296300
Name:BAKER, TAMMY LEE (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:TAMMY
Middle Name:LEE
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 1:4300 KY HWY 39 N
Mailing Address - Street 2:
Mailing Address - City:CRAB ORCHARD
Mailing Address - State:KY
Mailing Address - Zip Code:40419
Mailing Address - Country:US
Mailing Address - Phone:606-355-0072
Mailing Address - Fax:
Practice Address - Street 1:4300 KY HWY 39 N
Practice Address - Street 2:
Practice Address - City:CRAB ORCHARD
Practice Address - State:KY
Practice Address - Zip Code:40419
Practice Address - Country:US
Practice Address - Phone:606-355-0072
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYR2382225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist