Individual
MR. CRESTON ZANE BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCPC
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LC1532
MD
104100000X
Social Worker
LC1532
MD
Other
Enumeration date
07/28/2009
Last updated
05/24/2023
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