Provider Demographics
NPI:1073062675
Name:BAKER, CASSIE (MED BCBA)
Entity Type:Individual
Prefix:MRS
First Name:CASSIE
Middle Name:
Last Name:BAKER
Suffix:
Gender:F
Credentials:MED BCBA
Other - Prefix:MISS
Other - First Name:CASSIE
Other - Middle Name:
Other - Last Name:WAHLFELDT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3949 N RIVER RD
Mailing Address - Street 2:
Mailing Address - City:FREELAND
Mailing Address - State:MI
Mailing Address - Zip Code:48623-8856
Mailing Address - Country:US
Mailing Address - Phone:989-702-2082
Mailing Address - Fax:
Practice Address - Street 1:3949 N RIVER RD
Practice Address - Street 2:
Practice Address - City:FREELAND
Practice Address - State:MI
Practice Address - Zip Code:48623-8856
Practice Address - Country:US
Practice Address - Phone:989-702-2082
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-25
Last Update Date:2019-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No104100000XBehavioral Health & Social Service ProvidersSocial Worker