Individual
LARA CHRISTINE BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1707 PROFESSIONAL CIR, YUKON, OK 73099-6470
(678) 894-1116
Mailing address
1707 PROFESSIONAL CIR, YUKON, OK 73099-6470
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-23-259236
OK
Other
Enumeration date
07/24/2023
Last updated
07/24/2023
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