Individual
MATTHEW BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9233 WARD PKWY STE 125, KANSAS CITY, MO 64114-3340
(816) 561-9494
Mailing address
2219 W 79TH TER, PRAIRIE VILLAGE, KS 66208-3839
(816) 809-7697
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2018045596
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
490066785
—
MO
Enumeration date
08/17/2018
Last updated
12/29/2020
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