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General NPI Number Information
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NPI Number | 1578344941
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Entity Type | Organization
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Legal Business Name | NORTHEAST TEXAS BEHAVIORAL HEALTH
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Dates
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Enumeration Date | 10/11/2023
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Last Update Date | 10/11/2023
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Provider Practice Location Address
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Address Line | 3605 NE LOOP 286 STE 1800
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City | PARIS
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State | TX
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Zip | 75460-5086
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Country | US
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Telephone | 903-782-9500
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Fax |
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Provider Business Mailing Address
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Address Line | 3605 NE LOOP 286 STE 1800
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City | PARIS
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State | TX
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Zip | 75460-5086
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Country | US
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Telephone | 903-782-9500
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KAITLIN BAKER
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Credential | APRN, PMHNP-BC
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Telephone | 903-517-3967
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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