Provider Demographics
NPI:1558758433
Name:BAKER, ANDREA (MS)
Entity Type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:
Last Name:BAKER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 ERIE ST
Mailing Address - Street 2:NUMBER 6
Mailing Address - City:GOSHEN
Mailing Address - State:NY
Mailing Address - Zip Code:10924-1531
Mailing Address - Country:US
Mailing Address - Phone:845-294-1882
Mailing Address - Fax:
Practice Address - Street 1:60 ERIE ST
Practice Address - Street 2:NUMBER 6
Practice Address - City:GOSHEN
Practice Address - State:NY
Practice Address - Zip Code:10924-1531
Practice Address - Country:US
Practice Address - Phone:845-294-1882
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-19
Last Update Date:2015-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst