Individual
MRS. MARY ROXANNE BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LMHCA, NCC
Contact information
Practice address
926 E JACKSON BLVD, ELKHART, IN 46516-4351
(574) 575-6557
(574) 522-0481
Mailing address
926 E JACKSON BLVD, ELKHART, IN 46516-4351
(574) 522-6292
(574) 522-0481
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
309005026A
IN
101Y00000X
Counselor
88001264A
IN
101Y00000X
Counselor
99097331A
IN
Other
Enumeration date
02/19/2020
Last updated
10/30/2024
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