Individual
GABRIELLE BAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4071 E. 59TH ST., CLEVELAND, OH 44105
(216) 466-1676
Mailing address
4071 E 59TH ST, CLEVELAND, OH 44105-4815
(216) 466-1676
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
2894748
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2894748
—
OH
Enumeration date
05/13/2014
Last updated
05/13/2014
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