Provider Demographics
NPI:1184823213
Name:BAKER, EILEEN M (EDD)
Entity Type:Individual
Prefix:DR
First Name:EILEEN
Middle Name:M
Last Name:BAKER
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20228 WHITEHEAD CIR
Mailing Address - Street 2:
Mailing Address - City:REHOBOTH BEACH
Mailing Address - State:DE
Mailing Address - Zip Code:19971-7005
Mailing Address - Country:US
Mailing Address - Phone:302-373-4318
Mailing Address - Fax:
Practice Address - Street 1:1800 BAY AVE
Practice Address - Street 2:
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-1859
Practice Address - Country:US
Practice Address - Phone:302-645-9184
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-18
Last Update Date:2007-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEPC0000398101YP2500X
DE6354103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool