Provider Demographics
NPI:1063159945
Name:BAKER, CHRISTINA (MSW)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:BAKER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MS
Other - First Name:CHRISTINA
Other - Middle Name:LYNN
Other - Last Name:BAKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CHRISTINA JOHNSTON
Mailing Address - Street 1:1600 EUNICE LN
Mailing Address - Street 2:
Mailing Address - City:BAKER
Mailing Address - State:FL
Mailing Address - Zip Code:32531-8493
Mailing Address - Country:US
Mailing Address - Phone:614-806-8284
Mailing Address - Fax:
Practice Address - Street 1:1600 EUNICE LN
Practice Address - Street 2:
Practice Address - City:BAKER
Practice Address - State:FL
Practice Address - Zip Code:32531-8493
Practice Address - Country:US
Practice Address - Phone:614-806-8284
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-12
Last Update Date:2022-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLISW13201104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker