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CHARLENE M BAKER LADC

Addiction (Substance Use Disorder) >> Counselor >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1356861777

Individual Registrant:
 CHARLENE M BAKER LADC
Gender: F
Sole Proprietor

Location and contact information for practice:
38 BRIDGE ST  EAST WINDSOR, CT 06088-9679 US
Tel: 860-543-4309  Fax: --

Contact information for business:
PO BOX 594  EAST WINDSOR, CT 06088-0594 US
Tel: 860-543-9380  Fax: --

Registration Information:
NPI: 1356861777
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y101YA0400XBehavioral Health & Social Service Providers
Counselor
Addiction (Substance Use Disorder)
CT000869

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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