Individual
KATHLEEN L. BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7600 E FLORENTINE RD, PRESCOTT VALLEY, AZ 86314-1295
(928) 775-7088
(928) 634-8960
Mailing address
3859 E COMANCHE DR, COTTONWOOD, AZ 86326-5706
(928) 634-2236
(928) 634-8960
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LISAC-10663
AZ
Other
Enumeration date
09/17/2008
Last updated
10/28/2015
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