Provider Demographics
NPI:1831825561
Name:BAKER, EMMA
Entity type:Individual
Prefix:
First Name:EMMA
Middle Name:
Last Name:BAKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1916 REDWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:NICEVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32578-9500
Mailing Address - Country:US
Mailing Address - Phone:318-787-9995
Mailing Address - Fax:
Practice Address - Street 1:4565 COMMERCIAL DR STE 105
Practice Address - Street 2:
Practice Address - City:NICEVILLE
Practice Address - State:FL
Practice Address - Zip Code:32578-8856
Practice Address - Country:US
Practice Address - Phone:850-353-2415
Practice Address - Fax:850-353-2528
Is Sole Proprietor?:No
Enumeration Date:2022-07-26
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist