Provider Demographics
NPI:1801199898
Name:BAKER, SHERRY
Entity Type:Individual
Prefix:DR
First Name:SHERRY
Middle Name:
Last Name:BAKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 N. VANBUREN STREET
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48708-0000
Mailing Address - Country:US
Mailing Address - Phone:989-895-8356
Mailing Address - Fax:989-895-1197
Practice Address - Street 1:601 N. VANBUREN STREET
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48708-0000
Practice Address - Country:US
Practice Address - Phone:989-895-8356
Practice Address - Fax:989-895-1197
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-13
Last Update Date:2010-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401011414101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor