Individual
JACOB TYLER BAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
408 STONERIDGE CT, GRAND JUNCTION, CO 81507-1655
(334) 654-0456
Mailing address
408 STONERIDGE CT, GRAND JUNCTION, CO 81507-1655
(334) 654-0456
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
08/03/2019
Last updated
08/03/2019
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