Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | PS002668 | PA |
Y | 103T00000X | Psychologist | PS002668 | PA |
NPI | 1013971217 |
---|---|
Provider Name | Dr. Minna Rae Baker |
First Address | Narberth, PA 19072-1623 |
Second Address | Penn Valley, PA 19072-1623 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2006 |
Last Update Date | 25/01/2008 |