| NPI | 1497034961 |
|---|---|
| Former Name | KIMBERLY LATRICE BAKER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IN 20043807A) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: IL 071.008142) |
| 103TC0700X Psychologist, Clinical (Licence: PA PS020600) | |
| 103TC0700X Psychologist, Clinical (Licence: IL 71.008142) | |
| Enumeration Date | 2011-08-15 |
| Last Update Date | 2025-10-06 |