Individual
JENNA ANN BAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
928 BAYSIDE, BREEZY POINT, NY 11697-1136
(646) 372-1241
Mailing address
928 BAYSIDE, BREEZY POINT, NY 11697-1136
(646) 372-1241
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
04/25/2019
Last updated
04/25/2019
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