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General NPI Number Information
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NPI Number | 1487296554
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Entity Type | Individual
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Provider Name | HEATHER LYNETTE BAKER LPC-MHSP
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Gender | Female
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Dates
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Enumeration Date | 10/10/2019
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Last Update Date | 10/10/2019
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Provider Practice Location Address
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Address Line | 871 PROFESSIONAL PARK DR
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City | CLARKSVILLE
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State | TN
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Zip | 37040-5257
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Country | US
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Telephone | 931-206-3021
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Fax |
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Provider Business Mailing Address
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Address Line | 275 CUMBERLAND BND
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City | NASHVILLE
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State | TN
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Zip | 37228-1805
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Country | US
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Telephone | 615-782-6205
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 4828
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License Number State | TN
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