Individual
BROOKE BAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2323 S HARVARD AVE, TULSA, OK 74114-3301
(918) 293-2121
Mailing address
14100 E 106TH ST N APT 224, OWASSO, OK 74055-6059
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA
NA
—
Enumeration date
10/26/2021
Last updated
10/26/2021
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