Healthcare Provider Details
I. General information
NPI: 1659794964
Provider Name (Legal Business Name): MICHELLE CHRISTINE BAKER-RHODES M. ED.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/23/2014
Last Update Date: 01/23/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2441 NW 34TH ST
OKLAHOMA CITY OK
73112-7827
US
IV. Provider business mailing address
2441 NW 34TH ST
OKLAHOMA CITY OK
73112-7827
US
V. Phone/Fax
- Phone: 405-922-8378
- Fax:
- Phone: 405-922-8378
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YS0200X |
| Taxonomy | School Counselor |
| License Number | 302286 |
| License Number State | OK |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: