Individual
JACQUELINE BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5152 BROADWAY ST, SUITE 211, SAN ANTONIO, TX 78209-5735
(210) 824-1566
(818) 758-8015
Mailing address
19019 VENTURA BLVD, TARZANA, CA 91356-3253
(818) 345-2345
(818) 758-8015
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-14-16614
TX
Other
Enumeration date
07/07/2014
Last updated
03/05/2015
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