Individual provider · NPI-1

Amanda Baker, MS, LCDC

Counselor, Addiction (Substance Use Disorder) · Addison, TX

NPI number1811369671
StatusActive
Last updated in NPPESOct 20, 2015

Details

NPI
1811369671
Entity type
Individual (NPI-1)
Name
Amanda Baker
Credential
MS, LCDC
Sex
Female
Sole proprietor
Yes
Enumeration date
Oct 20, 2015
Last updated
Oct 20, 2015

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
101YA0400X Counselor, Addiction (Substance Use Disorder)11798TXYes

Practice location

4950 Keller Springs Rd Ste 310
Addison, TX 75001-6349

Phone 972-835-1963

Mailing address

4950 Keller Springs Rd Ste 310
Addison, TX 75001-6349

Phone 972-835-1963

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