| Mildred Baker Sole Member | |
|
601 Wilson Ave Roaring Spring PA 16673-1351 | |
| (814) 934-0303 | |
| (814) 317-0341 |
| Full Name | Mildred Baker Sole Member |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 601 Wilson Ave, Roaring Spring, Pennsylvania |
| Authorized Official Name and Position | Mildred Baker (OFFICER) |
| Authorized Official Contact | 8149340303 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mildred Baker Sole Member 601 Wilson Ave Roaring Spring PA 16673-1351 Ph: (814) 934-0303 | Mildred Baker Sole Member 601 Wilson Ave Roaring Spring PA 16673-1351 Ph: (814) 934-0303 |
| NPI Number | 1790005429 |
|---|---|
| Provider Enumeration Date | 06/04/2010 |
| Last Update Date | 06/04/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790005429 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | CW016550 (Pennsylvania) | Primary |
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