Individual
TIFFANY ALYCIA BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3407 SHAMROCK CT, GAUTIER, MS 39553-5337
(228) 497-0690
Mailing address
3407 SHAMROCK CT, GAUTIER, MS 39553-5337
(228) 497-0690
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
04/30/2019
Last updated
04/30/2019
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