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Individual

GAIL E BAKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
503 AVENUE H APT 503, BOISE, ID 83712-6433
(406) 461-7267
Mailing address
503 AVENUE H APT 503, BOISE, ID 83712-6433
(406) 461-7267

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
581 LCSW
MT
1041C0700X
Clinical Social Worker
LCSW-31504
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0000070495
BLUE CROSS/SHIELD OF MONT
MT
01
P00692103 C01340
RAILROAD MEDICARE PROVIDER NUMBER
MT
Enumeration date
02/09/2006
Last updated
10/19/2011
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