| Doctor Name: | ETHEL ANN BAKKE |
| NPI Number: | 1225345937 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC, NCC, LMHC, CAP |
| License Number: | 90988 |
| Business Practice Address: | 1342 Colonial Blvd Bldg. D, Ste. 13 Fort Myers, FL - 339071013 |
| Business Phone Number: | 2399314444 |
| Business Fax Number: | 2399314440 |
| Mailing Address: | 1342 Colonial Blvd, Bldg. D, Ste. 13 FORT MYERS |
| State: | FL |
| Postal Code: | 339071013 |
| Phone Number: | 2399314444 |
| Fax Number: | 2399314440 |
| NPI Enumeration Date: | 09/02/2010 |
| NPI Last Update Date: | 09/02/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101Y00000X |
| License Number: | 90988 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |