Healthcare Provider Details

I. General information

NPI: 1114711413
Provider Name (Legal Business Name): FAITH BAKER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2025
Last Update Date: 06/08/2025
Certification Date: 06/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 MADISON AVE STE 200
TOLEDO OH
43604-1230
US

IV. Provider business mailing address

5963 KENTSHIRE DR STE A
DAYTON OH
45440-4253
US

V. Phone/Fax

Practice location:
  • Phone: 567-312-8700
  • Fax:
Mailing address:
  • Phone: 937-952-6379
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: