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Individual

MS. SANDRA CAROLINE BAKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CSAC

Contact information

Practice address
2625 N WEIL ST, MILWAUKEE, WI 53212-3060
(414) 962-1200
(414) 962-2305
Mailing address
2625 N WEIL ST, MILWAUKEE, WI 53212-3060
(414) 962-1200
(414) 962-2305

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
12129132
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
12129132
DEPT OF REGULATION LIC
WI
05
39388400
WI
Enumeration date
11/01/2007
Last updated
08/22/2014
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