Individual
GENE ALLEN BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D, HSPP
Contact information
Practice address
335 SPRING ST, JEFFERSONVLLE, IN 47130-4480
(812) 258-0310
(812) 258-0409
Mailing address
645 S ROGERS ST, BLOOMINGTON, IN 47403-2353
(812) 339-1694
(812) 337-2438
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
20042705A
IN
106H00000X
Marriage & Family Therapist
0219
KY
106H00000X
Marriage & Family Therapist
35001453A
IN
106H00000X
Marriage & Family Therapist
F . 1100008
OH
Other
Enumeration date
12/12/2011
Last updated
11/18/2013
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