Individual
MR. KENNETH JAMES BAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
2209 E COMISKY ST, MERIDIAN, ID 83646-4742
(208) 860-5777
Mailing address
2209 E COMISKY ST, MERIDIAN, ID 83646-4742
(208) 860-5777
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC-3836
ID
Other
Enumeration date
04/02/2013
Last updated
04/02/2013
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