Healthcare Provider Details

I. General information

NPI: 1831031814
Provider Name (Legal Business Name): BRITTANY BAKER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2026
Last Update Date: 04/08/2026
Certification Date: 04/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5651 COVENTRY LN # 112
FORT WAYNE IN
46804-7145
US

IV. Provider business mailing address

5651 COVENTRY LN # 112
FORT WAYNE IN
46804-7145
US

V. Phone/Fax

Practice location:
  • Phone: 260-205-8644
  • Fax: 260-265-1706
Mailing address:
  • Phone: 260-205-8644
  • Fax: 260-265-1706

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: