Individual
MS. MARY EILEEN BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
10605 JUDICIAL DR STE A1, FAIRFAX, VA 22030-5116
(240) 350-8696
Mailing address
10605 JUDICIAL DR STE A1, FAIRFAX, VA 22030-5116
(240) 350-8696
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701005278
VA
101YP2500X
Professional Counselor
LC2012
MD
Other
Enumeration date
09/22/2006
Last updated
12/14/2020
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