Individual
MS. BRENDA K BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW
Contact information
Practice address
19 ROAD 3953, FARMINGTON, NM 87401-7990
(505) 486-9942
Mailing address
19 ROAD 3953, FARMINGTON, NM 87401-7990
(505) 486-9942
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
M-06619
NM
1041C0700X
Clinical Social Worker
Primary
I-07304
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
28005775
—
NM
Enumeration date
04/25/2008
Last updated
01/26/2011
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