Healthcare Provider Details

I. General information

NPI: 1366069783
Provider Name (Legal Business Name): PAIGE BAKER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/01/2020
Last Update Date: 08/19/2025
Certification Date: 08/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2737 YOUNGSTOWN RD SE
WARREN OH
44484-5002
US

IV. Provider business mailing address

2737 YOUNGSTOWN RD SE
WARREN OH
44484-5002
US

V. Phone/Fax

Practice location:
  • Phone: 330-369-8022
  • Fax:
Mailing address:
  • Phone: 330-369-8022
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCDCA.192121
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMA061664
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: