Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 271009 | KY |
NPI | 1003467937 |
---|---|
Provider Name | Mrs. Cheyanna Hope Baker |
First Address | Lawrenceburg, KY 40342-1495 |
Second Address | Lexington, KY 40507-1925 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/09/2019 |
Last Update Date | 30/07/2021 |