Individual
MS. JACQUELINE BAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
REGISTERED IMH14441
Contact information
Practice address
580 ELLIS RD S, JACKSONVILLE, FL 32254-3582
(904) 423-0017
Mailing address
3601 W COMMERCIAL BLVD STE 35, FORT LAUDERDALE, FL 33309-3329
(954) 677-8787
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
Other
Enumeration date
08/21/2015
Last updated
03/29/2018
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