Doctor Name: | MELISSA BAKER |
NPI Number: | 1104130731 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S. |
License Number: | |
Business Practice Address: | 22 Gregory Rd Hannibal, NY - 130742320 |
Business Phone Number: | 3153429255 |
Business Fax Number: | 3158663236 |
Mailing Address: | 22 Gregory Rd, HANNIBAL |
State: | NY |
Postal Code: | 130742320 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 08/06/2010 |
NPI Last Update Date: | 08/06/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |