Individual
SHAQUENNA BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
113 CHIPPER LN, SPARTA, GA 31087-2215
(478) 251-3745
Mailing address
113 CHIPPER LN, SPARTA, GA 31087-2215
(478) 251-3745
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
103TC1900X
Counseling Psychologist
—
—
103TP0814X
Psychoanalysis Psychologist
—
—
103TP2701X
Group Psychotherapy Psychologist
—
—
171W00000X
Contractor
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/03/2020
Last updated
09/03/2020
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