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Individual

MR. EDWIN G BAKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LICSW LADC

Contact information

Practice address
31 LOWER MAIN ST, MORRISVILLE, VT 05661-0919
(802) 888-3600
Mailing address
PO BOX 919, 31 MAIN ST, MORRISVILLE, VT 05661-0919
(802) 888-3600

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
000014
VT
1041C0700X
Clinical Social Worker
0890000161
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1006728
VT
Enumeration date
11/09/2006
Last updated
02/26/2008
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