Individual
DR. JOHN EDGAR BAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
68 LEONARD ST, 2ND FLOOR, BELMONT, MA 02478-2522
(617) 484-4447
(781) 641-0457
Mailing address
68 LEONARD ST, 2ND FLOOR, BELMONT, MA 02478-2522
(617) 484-4447
(781) 641-0457
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
3118
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
W03227
BLUE CROSS BLUE SHIELD
MA
Enumeration date
02/16/2007
Last updated
08/10/2007
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