Individual
MS. ILENE BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISAC
Contact information
Practice address
1650 E FORT LOWELL RD, SUITE 202, TUCSON, AZ 85719-2374
(520) 327-4505
(520) 202-1889
Mailing address
1650 E FORT LOWELL RD, SUITE 202, TUCSON, AZ 85719-2374
(520) 327-4505
(520) 202-1889
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LISAC-10560
AZ
Other
Enumeration date
05/27/2011
Last updated
05/27/2011
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