| NPI | 1821411679 |
|---|---|
| Former Name | JACQUELINE BAKER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: NM 0180001) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: NM 165721) |
| Enumeration Date | 2014-01-30 |
| Last Update Date | 2016-08-08 |