Individual
LAIEL INEZ BAKER-DEKREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD, LP
Contact information
Practice address
1772 STIEGER LAKE LN STE 220, VICTORIA, MN 55386-7723
(952) 443-4600
(952) 443-4604
Mailing address
PO BOX 51, VICTORIA, MN 55386-0051
(952) 443-4600
(952) 443-4604
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
MN5230
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
680002891
—
MN
Enumeration date
03/10/2010
Last updated
04/08/2019
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