Provider Demographics
NPI:1699977215
Name:BRICE-BAKER, JANET ROCHELLE (PHD)
Entity type:Individual
Prefix:DR
First Name:JANET
Middle Name:ROCHELLE
Last Name:BRICE-BAKER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:81 DRAKE RD
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-2366
Mailing Address - Country:US
Mailing Address - Phone:732-937-9454
Mailing Address - Fax:
Practice Address - Street 1:178 LIVINGSTON AVE
Practice Address - Street 2:
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901-2938
Practice Address - Country:US
Practice Address - Phone:732-937-9454
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJSI 02721103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical