Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC2200X | Clinical Child & Adolescent Psychologist |
NPI | 1043829351 |
---|---|
Provider Name | Lorien Baker |
First Address | New York, NY 10016-5818 |
Second Address | New York, NY 10016-5818 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/07/2020 |
Last Update Date | 18/02/2021 |