Provider Demographics
NPI:1578576229
Name:BAKER, MINDY LEE (BS, BHRS, CM-A)
Entity Type:Individual
Prefix:MS
First Name:MINDY
Middle Name:LEE
Last Name:BAKER
Suffix:
Gender:F
Credentials:BS, BHRS, CM-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10801 W. HWY. 66
Mailing Address - Street 2:APT. 298
Mailing Address - City:YUKON
Mailing Address - State:OK
Mailing Address - Zip Code:73099
Mailing Address - Country:US
Mailing Address - Phone:405-306-3739
Mailing Address - Fax:
Practice Address - Street 1:1501 W. COMMERCE
Practice Address - Street 2:
Practice Address - City:YUKON
Practice Address - State:OK
Practice Address - Zip Code:73099
Practice Address - Country:US
Practice Address - Phone:405-354-1927
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health