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General NPI Number Information
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NPI Number | 1629875414
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Entity Type | Individual
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Provider Name | SHELBY BAKER
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Gender | Female
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Dates
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Enumeration Date | 02/27/2025
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Last Update Date | 02/27/2025
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Provider Practice Location Address
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Address Line | 122 S MAIN ST STE 270
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City | ANN ARBOR
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State | MI
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Zip | 48104-1932
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Country | US
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Telephone | 734-325-4375
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Fax |
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Provider Business Mailing Address
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Address Line | 29933 JOHN HAUK ST
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City | GARDEN CITY
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State | MI
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Zip | 48135-2315
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Country | US
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Telephone |
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 6851119534
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License Number State | MI
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