Individual
ANDREW ALAN BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CDCA
Contact information
Practice address
597 PARK AVE E, MANSFIELD, OH 44905-2848
(419) 774-3536
Mailing address
597 PARK AVE E, MANSFIELD, OH 44905-2848
(419) 774-3536
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
011390
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0125695
—
OH
Enumeration date
12/01/2017
Last updated
12/01/2017
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