Individual
KATHRYN A BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Mailing address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2505
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39146200
—
WI
Enumeration date
06/15/2005
Last updated
03/23/2016
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