| Doctor Name: | MR. JOHN ALBERT BAKEROFSKIE |
| NPI Number: | 1306050554 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.A. |
| License Number: | |
| Business Practice Address: | 1287 County Welfare Rd Leesport, PA - 195339197 |
| Business Phone Number: | 6102084800 |
| Business Fax Number: | |
| Mailing Address: | 3940 Locust Ln, HARRISBURG |
| State: | PA |
| Postal Code: | 171094023 |
| Phone Number: | 5702943448 |
| Fax Number: | |
| NPI Enumeration Date: | 05/09/2007 |
| NPI Last Update Date: | 07/08/2007 |
| 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: | |