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General NPI Number Information
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NPI Number | 1134250780
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Entity Type | Individual
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Provider Name | LAURA CHRISTINE BAKER PH.D.
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Gender | Female
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Dates
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Enumeration Date | 03/07/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 312 S WASHINGTON ST SUITE 2B
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City | ALEXANDRIA
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State | VA
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Zip | 22314-3684
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Country | US
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Telephone | 703-585-5205
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Fax | 703-535-7332
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Provider Business Mailing Address
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Address Line | 312 S WASHINGTON ST SUITE 2B
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City | ALEXANDRIA
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State | VA
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Zip | 22314-3684
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Country | US
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Telephone | 703-585-5205
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Fax | 703-535-7332
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY1000026
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License Number State | VA
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