Individual
MR. LAMONT VAN BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
500 W 10TH STREET, WILMINGTON, DE 19801
(302) 230-9192
(302) 691-1100
Mailing address
500 W 10TH STREET, WILMINGTON, DE 19801
(302) 230-9192
(302) 691-1100
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1689733792
—
DE
Enumeration date
09/27/2010
Last updated
11/08/2012
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