Individual
JUDY BAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCDC
Contact information
Practice address
2915 S INTERSTATE 35 W, BURLESON, TX 76028-1445
(817) 447-3001
Mailing address
809 NEWPORT RD, FORT WORTH, TX 76120-2827
(214) 532-9316
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
9988
TX
Other
Enumeration date
08/11/2014
Last updated
08/11/2014
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