Provider Demographics
NPI:1346954179
Name:BAKER, DANIELLE (RDN)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:BAKER
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1726 HOWARD ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48216-1921
Mailing Address - Country:US
Mailing Address - Phone:313-832-3300
Mailing Address - Fax:
Practice Address - Street 1:1726 HOWARD ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48216-1921
Practice Address - Country:US
Practice Address - Phone:313-832-3300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-06
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN86056207133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered