Provider Demographics
NPI:1831842061
Name:BAKER, KIMBERLY JOY (OCC THERAPIST)
Entity type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:JOY
Last Name:BAKER
Suffix:
Gender:F
Credentials:OCC THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7150 GRANITE CIR STE 200
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43617-3114
Mailing Address - Country:US
Mailing Address - Phone:419-309-5880
Mailing Address - Fax:
Practice Address - Street 1:7150 GRANITE CIR STE 200
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43617-3114
Practice Address - Country:US
Practice Address - Phone:419-309-5880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-28
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT005243225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist