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Individual

MR. JENSON LIONEL BAKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MS, QMHP

Contact information

Practice address
3801 KING STREET, PORTSMOUTH, VA 23707-2370
(757) 673-2950
(757) 673-2951
Mailing address
504 CHANDLER HARPER DR, PORTSMOUTH, VA 23701-2108
(757) 817-6535
(757) 484-1553

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1765
VA

Other

Enumeration date
08/15/2012
Last updated
07/08/2019
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