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Individual

MS. URSULA PAULA BAKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
BS; LISAC

Contact information

Practice address
1301 W SECOND ST, WINSLOW, AZ 86047-3005
(928) 289-2650
(928) 289-0477
Mailing address
1301 W SECOND ST, WINSLOW, AZ 86047-3005
(928) 289-2650
(928) 289-0477

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LISAC-0091
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
162282
AHCCCS
AZ
Enumeration date
11/13/2008
Last updated
11/13/2008
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