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Individual

MR. KEVIN DALE BAKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MA, LPC

Contact information

Practice address
2226 HOMECREST AVE, KALAMAZOO, MI 49001
(269) 303-0345
Mailing address
2226 HOMECREST AVE, KALAMAZOO, MI 49001-4551
(269) 303-0345

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
6401010547
MI
101YM0800X
Mental Health Counselor
Primary
6401010547
MI

Other

Enumeration date
05/07/2009
Last updated
05/20/2013
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