Individual
MISS BRENDA LOU BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.C.S.W.,L.A.D.A.C.
Contact information
Practice address
4210 N FRONTAGE RD, SUITE 3, FAYETTEVILLE, AR 72703-5001
(479) 409-1400
(479) 301-2305
Mailing address
940 W BOONE ST, FAYETTEVILLE, AR 72701-6813
(479) 409-1400
(479) 301-2305
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1765-C
AR
Other
Enumeration date
06/01/2011
Last updated
10/01/2012
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