Provider Demographics
NPI:1821379702
Name:BAKER, ANNETTE CHRISTINE (PHD)
Entity Type:Individual
Prefix:DR
First Name:ANNETTE
Middle Name:CHRISTINE
Last Name:BAKER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10931 RAVEN RIDGE RD
Mailing Address - Street 2:SUITE 109
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27614-6499
Mailing Address - Country:US
Mailing Address - Phone:919-841-5555
Mailing Address - Fax:919-841-5560
Practice Address - Street 1:10931 RAVEN RIDGE RD
Practice Address - Street 2:SUITE 109
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27614-6499
Practice Address - Country:US
Practice Address - Phone:919-841-5555
Practice Address - Fax:919-841-5560
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-06
Last Update Date:2011-09-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC1836103TC0700X, 103TF0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic