Provider Demographics
NPI:1588093090
Name:KENDRICKS-BAKER, LORENA ELAINE (MS MFT)
Entity type:Individual
Prefix:MRS
First Name:LORENA
Middle Name:ELAINE
Last Name:KENDRICKS-BAKER
Suffix:
Gender:F
Credentials:MS MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7345 S DURANGO DR
Mailing Address - Street 2:# B107-371
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-3653
Mailing Address - Country:US
Mailing Address - Phone:702-672-2549
Mailing Address - Fax:
Practice Address - Street 1:7345 S DURANGO DR
Practice Address - Street 2:# B107-371
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113-3653
Practice Address - Country:US
Practice Address - Phone:702-672-2549
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-05
Last Update Date:2013-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVMI0411106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist