Provider Demographics
NPI:1356074983
Name:BAKER, KRISTEEN M (MS, ALC)
Entity Type:Individual
Prefix:
First Name:KRISTEEN
Middle Name:M
Last Name:BAKER
Suffix:
Gender:F
Credentials:MS, ALC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 161
Mailing Address - Street 2:
Mailing Address - City:RYLAND
Mailing Address - State:AL
Mailing Address - Zip Code:35767-0161
Mailing Address - Country:US
Mailing Address - Phone:256-755-6772
Mailing Address - Fax:
Practice Address - Street 1:3054 LEEMAN FERRY RD SW STE Q
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-5660
Practice Address - Country:US
Practice Address - Phone:256-755-6772
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-01
Last Update Date:2022-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor