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NPI Code Detail

MEDICARE: HEATHER LYNN BAKER L.C.S.W.

MEDICARE: HEATHER LYNN BAKER L.C.S.W.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker2886OK

General Provider Information

NPI Number : 1063544310
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEATHER LYNN BAKER L.C.S.W.
Provider Business Mailing Address
First Line : 2601 SPENCER RD
Second Line :
City : SPENCER
State : OK
Zip : 73084-3649
Country : US
Telephone Number : 405-229-2688
Fax Number :
Provider Business Practice Location Address
First Line : 2601 SPENCER RD
Second Line :
City : SPENCER
State : OK
Zip : 73084-3649
Country : US
Telephone Number : 405-427-2441
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/12/2007
Last Update Date : 09/02/2008

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Directions to “ HEATHER LYNN BAKER L.C.S.W.” Practice Location

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