Provider Demographics
NPI:1326052127
Name:BAKER-HARGROVE, DAVID (PHD, LMHC, DAPA)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:BAKER-HARGROVE
Suffix:
Gender:M
Credentials:PHD, LMHC, DAPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:934 N MAGNOLIA AVE
Mailing Address - Street 2:SUITE 234
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-3840
Mailing Address - Country:US
Mailing Address - Phone:407-963-5664
Mailing Address - Fax:407-896-0037
Practice Address - Street 1:934 N MAGNOLIA AVE
Practice Address - Street 2:SUITE 234
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-3840
Practice Address - Country:US
Practice Address - Phone:407-963-5664
Practice Address - Fax:407-896-0037
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH6562101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health