Doctor Name: | KELLI BAKER |
NPI Number: | 1013348812 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | B.S. SLP-ASSISTANT |
License Number: | 35682 |
Business Practice Address: | 16835 Deer Creek Dr Suite 120 Spring, TX - 773794968 |
Business Phone Number: | 2813794373 |
Business Fax Number: | |
Mailing Address: | 16835 Deer Creek Dr, Suite 120 SPRING |
State: | TX |
Postal Code: | 773794968 |
Phone Number: | 2813794373 |
Fax Number: | |
NPI Enumeration Date: | 12/03/2013 |
NPI Last Update Date: | 12/03/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2355S0801X |
License Number: | 35682 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Specialist/Technologist |
Taxonomy Specialization: | Speech-Language Assistant |
Taxonomy Definition: |