Individual
JEDEDIAH BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LSW, CADC
Contact information
Practice address
45 WYNTRE BROOKE DR, LOWER LEVEL, YORK, PA 17403-4536
(610) 644-6464
(610) 981-6078
Mailing address
1440 RUSSELL RD, PAOLI, PA 19301-1236
(610) 644-6464
(610) 981-6078
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
SW130701
PA
Other
Enumeration date
01/29/2014
Last updated
01/29/2014
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