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Individual

ETHEL ANN BAKKE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC, NCC, LMHC, CAP

Contact information

Practice address
253 LEWIS LN STE 101, HAVRE DE GRACE, MD 21078-3755
(321) 474-4661
Mailing address
253 LEWIS LN STE 101, HAVRE DE GRACE, MD 21078-3755
(321) 474-4661

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
90988
MI
101YM0800X
Mental Health Counselor
6401009158
MI
101YM0800X
Mental Health Counselor
Primary
LC8445
MD
101YM0800X
Mental Health Counselor
MH10373
FL

Other

Enumeration date
09/02/2010
Last updated
11/21/2024
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