Individual
DUSTIN BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RECOVERY ASSISTANT
Contact information
Practice address
210 N SHAMROCK BLVD, RUSSELLVILLE, AR 72802-9658
(479) 705-1301
Mailing address
PO BOX 1589, BENTON, AR 72018-1589
(501) 315-3344
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
10334-M
AR
1041C0700X
Clinical Social Worker
Primary
10334-C
AR
171M00000X
Case Manager/Care Coordinator
—
AR
Other
Enumeration date
08/14/2012
Last updated
09/06/2023
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