Individual
TANESHA LYNN BAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
555 WOODED RUN RD, FELICITY, OH 45120-9518
(937) 515-8651
Mailing address
555 WOODED RUN RD, FELICITY, OH 45120-9518
(937) 515-8651
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
05/07/2024
Last updated
05/07/2024
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