| NPI | 1811279482 |
|---|---|
| Former Name | OPHELIA MARLENE BAKER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC011218) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: KS LCPC2305) |
| Enumeration Date | 2011-09-09 |
| Last Update Date | 2023-06-12 |