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General NPI Number Information
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NPI Number | 1528174083
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Entity Type | Individual
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Provider Name | BONNIE BAKER LCSW
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Gender | Female
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Dates
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Enumeration Date | 08/21/2006
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Last Update Date | 10/09/2009
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Provider Practice Location Address
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Address Line | 6175 NW 153 ST #404
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City | MIAMI LAKES
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State | FL
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Zip | 33014
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Country | US
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Telephone | 305-558-7400
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Fax | 305-558-6134
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Provider Business Mailing Address
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Address Line | 3301 N COUNTRY CLUB DR #801
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City | AVENTURA
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State | FL
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Zip | 33180
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Country | US
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Telephone | 305-244-4887
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Fax | 305-558-6134
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | SW6815
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License Number State | FL
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