Provider Demographics
NPI:1124790571
Name:BAKER, KRISTEN M
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:M
Last Name:BAKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1125 WEST ST STE 245&254
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-4198
Mailing Address - Country:US
Mailing Address - Phone:770-820-4391
Mailing Address - Fax:
Practice Address - Street 1:1125 WEST ST STE 245&254
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-4198
Practice Address - Country:US
Practice Address - Phone:770-820-4391
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-04
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor