Individual
MR. BRAXTON BAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS CCC-SLP
Contact information
Practice address
4341 LOCUST ST, KANSAS CITY, MO 64110
(417) 766-0797
Mailing address
104 N BRIGGS ST, GRANT CITY, MO 64456-8404
(141) 776-6797
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2012029904
MO
Other
Enumeration date
06/28/2010
Last updated
09/21/2012
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