Individual
LAKEITHA CHANTEL BAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
35761 SAM BAKER DR, GEISMAR, LA 70734-3348
(225) 313-0658
Mailing address
PO BOX 323, GEISMAR, LA 70734-0323
(225) 313-0658
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
405300000X
Prevention Professional
0000000000
LA
Other
Enumeration date
01/24/2019
Last updated
01/24/2019
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