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General NPI Number Information
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NPI Number | 1033736715
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Entity Type | Organization
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Legal Business Name | SHEENA BAKER PLLC
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Dates
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Enumeration Date | 06/29/2020
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Last Update Date | 10/08/2020
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Provider Practice Location Address
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Address Line | 1219 MILLENNIUM PKWY STE 109
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City | BRANDON
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State | FL
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Zip | 33511-3891
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Country | US
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Telephone | 405-808-4900
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Fax |
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Provider Business Mailing Address
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Address Line | 5019 CLOVER MIST DR
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City | APOLLO BEACH
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State | FL
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Zip | 33572-3415
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Country | US
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Telephone | 405-808-4900
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Fax |
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Authorized Official
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Title or Position | OWNER/CLINICIAN
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Name | SHEENA BAKER
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Credential | LCSW
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Telephone | 405-808-4900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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