Individual
MRS. SHAKILA TALYNN HENDERSON-BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSCP, MHP
Contact information
Practice address
175 GWINNETT DR, LAWRENCEVILLE, GA 30045-8444
(770) 339-5377
(770) 339-5016
Mailing address
105 WHITEHEAD DR, COVINGTON, GA 30016-8228
(770) 788-0982
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
12/17/2007
Last updated
12/17/2007
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