Individual
BENJAMIN BRYCE BAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1619 DAYTON AVE STE 309, SAINT PAUL, MN 55104-6276
(515) 480-8396
Mailing address
424 REHNBERG PL, WEST SAINT PAUL, MN 55118-3213
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
4240
MN
Other
Enumeration date
01/31/2023
Last updated
01/31/2023
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