Provider Demographics
NPI:1275683468
Name:BAKER, ELIZABETH (PHD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:
Last Name:BAKER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59 GRANITE ST
Mailing Address - Street 2:
Mailing Address - City:FOXBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02035-1730
Mailing Address - Country:US
Mailing Address - Phone:508-543-4626
Mailing Address - Fax:
Practice Address - Street 1:60 HODGES AVE
Practice Address - Street 2:TAUNTON STATE HOSPITAL
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780-3034
Practice Address - Country:US
Practice Address - Phone:508-977-3299
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2380103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2380OtherLICENSED PSYCHOLOGIST