Individual
MS. BRENDA JEANNE BAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, BCBA, LMT
Contact information
Practice address
804 MOHAWK PKWY APT 104, CAPE CORAL, FL 33914-5750
(239) 784-3741
(239) 236-1718
Mailing address
804 MOHAWK PKWY APT 104, CAPE CORAL, FL 33914-5750
(239) 784-3741
(239) 236-1718
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-09-5040
FL
225700000X
Massage Therapist
MA 57488
FL
Other
Enumeration date
04/02/2010
Last updated
04/06/2010
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