Provider Demographics
NPI:1053505974
Name:BAKER-MULFORD, ANTOINETTE LOUISE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ANTOINETTE
Middle Name:LOUISE
Last Name:BAKER-MULFORD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:TONI
Other - Middle Name:LOUISE
Other - Last Name:MULFORD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:1330 W 26TH ST
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16508-1402
Mailing Address - Country:US
Mailing Address - Phone:814-459-9300
Mailing Address - Fax:
Practice Address - Street 1:5100 PEACH ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16509
Practice Address - Country:US
Practice Address - Phone:814-866-4500
Practice Address - Fax:814-866-2677
Is Sole Proprietor?:No
Enumeration Date:2007-09-04
Last Update Date:2021-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0152041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical