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1356759187
BRENT TYLER BAKER
CORBIN, KY
NPI
1356759187
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2014-07-24
Last Update Date
2014-08-13
Business Address
-- BRENT TYLER BAKER BA
1203 AMERICAN GREETING CARD RD
CORBIN, KY 40701-4811
Phone number: 606-528-7010
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Mailing Address
-- BRENT TYLER BAKER BA
PO BOX 568
CORBIN, KY 40702-0568
Phone number: 606-528-7010
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