Individual
DEITRA BAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
9800 HILLWOOD PKWY, FORT WORTH, TX 76177-1527
(817) 617-7363
Mailing address
10016 SHELBURNE RD, FORT WORTH, TX 76244-8524
(404) 217-9619
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
203614
TX
Other
Enumeration date
02/26/2020
Last updated
02/26/2020
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