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General NPI Number Information
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NPI Number | 1417361130
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Entity Type | Individual
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Provider Name | JOEL BAKER MA
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Gender | Male
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Dates
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Enumeration Date | 06/20/2014
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Last Update Date | 04/22/2022
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Provider Practice Location Address
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Address Line | 199 ARMOUR DR NE STE E
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City | ATLANTA
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State | GA
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Zip | 30324-3975
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Country | US
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Telephone | 678-948-8057
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Fax |
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Provider Business Mailing Address
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Address Line | 199 ARMOUR DR NE STE E
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City | ATLANTA
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State | GA
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Zip | 30324-3975
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Country | US
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Telephone | 678-948-8057
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Fax |
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFT001327
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License Number State | GA
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