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Individual

STUART M BAKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LADC

Contact information

Practice address
1 LONG WHARF DR, STE 10, NEW HAVEN, CT 06511-5991
(203) 781-4600
(203) 781-4624
Mailing address
1 LONG WHARF DR, STE 321, NEW HAVEN, CT 06511-5991
(203) 781-4600
(203) 781-4624

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
000014
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004041000
CT
05
008003745
CT
05
008038036
CT
Enumeration date
12/07/2011
Last updated
01/23/2013
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