Provider Demographics
NPI:1326304965
Name:BAECKER, JAIMIE DONELLE (MA)
Entity Type:Individual
Prefix:
First Name:JAIMIE
Middle Name:DONELLE
Last Name:BAECKER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 N PALAFOX ST
Mailing Address - Street 2:STE 103
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32501-2664
Mailing Address - Country:US
Mailing Address - Phone:850-266-2700
Mailing Address - Fax:
Practice Address - Street 1:1300 N PALAFOX ST
Practice Address - Street 2:STE 103
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32501-2664
Practice Address - Country:US
Practice Address - Phone:850-266-2700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-09
Last Update Date:2012-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health