Individual
MARY SUZANNE BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1100 E LAKE ST, TYLER, TX 75701-3343
(817) 734-4920
Mailing address
11937 US HIGHWAY 271, TYLER, TX 75708-3154
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
39098
TX
Other
Enumeration date
07/25/2022
Last updated
07/25/2022
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