Individual
SUSAN BAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D
Contact information
Practice address
39 STANLEY AVE, MEDFORD, MA 02155-5617
(781) 395-1281
Mailing address
39 STANLEY AVE, MEDFORD, MA 02155-5617
(781) 395-1281
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
4513-PY-PR
MA
Other
Enumeration date
06/11/2018
Last updated
06/11/2018
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