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Individual

MS. JO ANNE BAKEMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN, CASAC

Contact information

Practice address
163 S 1ST ST, FULTON, NY 13069-1721
(315) 427-3899
(315) 458-2538
Mailing address
202 E PATRICIA LN, NORTH SYRACUSE, NY 13212-3218
(315) 458-2538
(315) 458-2538

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
4364
NY
163W00000X
Registered Nurse
252125-1
NY

Other

Enumeration date
04/03/2013
Last updated
04/03/2013
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