Individual
DR. MONTY TIMOTHY BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
2200 BERGQUIST DR, STE. 1, LIFE SKILLS SUPPORT CENTER, 59 MDOS MMCM, LACKLAND A F B, TX 78236-9907
(210) 292-7361
(210) 292-2520
Mailing address
2200 BERGQUIST DR, STE. 1, LIFE SKILLS SUPPORT CENTER, 59 MDOS MMCM, LACKLAND A F B, TX 78236-9907
(210) 292-7361
(210) 292-2520
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY 7200
FL
Other
Enumeration date
09/30/2005
Last updated
07/08/2007
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